Provider Demographics
NPI:1073516704
Name:SCHMIDT, PAUL A (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 SW BIG BEND TRL
Mailing Address - Street 2:
Mailing Address - City:GLEN ROSE
Mailing Address - State:TX
Mailing Address - Zip Code:76043-4449
Mailing Address - Country:US
Mailing Address - Phone:254-897-3444
Mailing Address - Fax:254-897-9973
Practice Address - Street 1:507 SW BIG BEND TRL
Practice Address - Street 2:
Practice Address - City:GLEN ROSE
Practice Address - State:TX
Practice Address - Zip Code:76043-4449
Practice Address - Country:US
Practice Address - Phone:254-897-3444
Practice Address - Fax:254-897-9973
Is Sole Proprietor?:No
Enumeration Date:2005-05-26
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133448410Medicaid
TX460509907OtherEIN
TX133448409Medicaid
TX133448406Medicaid
TXB88070Medicare UPIN
TX8F2233Medicare PIN