Provider Demographics
NPI:1073675625
Name:SCHULZE, THOMAS WALTON (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WALTON
Last Name:SCHULZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W 34TH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1205
Mailing Address - Country:US
Mailing Address - Phone:512-450-1001
Mailing Address - Fax:512-302-9723
Practice Address - Street 1:720 W 34TH ST STE 210
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1205
Practice Address - Country:US
Practice Address - Phone:512-450-1001
Practice Address - Fax:512-302-9723
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3393207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology