Provider Demographics
NPI:1073523767
Name:SCHWARZ, TRACY A (LSA)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:A
Last Name:SCHWARZ
Suffix:
Gender:F
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 WEGNER RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-2482
Mailing Address - Country:US
Mailing Address - Phone:830-964-3735
Mailing Address - Fax:830-964-3735
Practice Address - Street 1:4320 WEGNER RD
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-2482
Practice Address - Country:US
Practice Address - Phone:830-964-3735
Practice Address - Fax:830-964-3735
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00228246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0058LFOtherBLUE CROSS BLUE SHIELD