Provider Demographics
NPI:1053495788
Name:SCHWARTZ, DAVID MATTHEW (DPM, RPH)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MATTHEW
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DPM, RPH
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:MATTHEW
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM, RPH
Mailing Address - Street 1:1320 GOLD COAST DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-2404
Mailing Address - Country:US
Mailing Address - Phone:214-997-3668
Mailing Address - Fax:972-692-5269
Practice Address - Street 1:1320 GOLD COAST DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-2404
Practice Address - Country:US
Practice Address - Phone:214-997-3668
Practice Address - Fax:972-692-5269
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2022-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39700183500000X
MA21352183500000X
MA2176213E00000X
TX1653213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX039250802Medicaid
TX00798PMedicare ID - Type Unspecified