Provider Demographics
NPI:1063506913
Name:SCHULTZ, KAREN D (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:D
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:1500 COOPER ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2710
Practice Address - Country:US
Practice Address - Phone:682-885-6299
Practice Address - Fax:682-885-1090
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK78862080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129452100OtherFIRSTCARE PIN
1750369203OtherGRP NPI NUMBER
TX8H3660OtherBCBSTX IND PIN
TX00U87ZOtherBCBSTX GRP PIN
TX2314376OtherUHC PIN
TX7590469OtherAETNA PIN
TX10008910OtherAMERIGROUP PIN
TX124186OtherSUPERIOR PIN
TX2110710OtherFIRSTHEALTH PIN
TX9834910OtherCIGNA PIN
TX159529007Medicaid
TX00U87ZOtherBCBSTX GRP PIN
TX10008910OtherAMERIGROUP PIN