Provider Demographics
NPI:1083248728
Name:SCHMIDT, NATHAN
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29077 BULVERDE RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-1701
Mailing Address - Country:US
Mailing Address - Phone:210-799-9820
Mailing Address - Fax:210-855-7233
Practice Address - Street 1:29077 BULVERDE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-1701
Practice Address - Country:US
Practice Address - Phone:210-799-9820
Practice Address - Fax:210-855-7233
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20414171W00000X, 171WH0202X
171WV0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications
No171W00000XOther Service ProvidersContractor
No171WV0202XOther Service ProvidersContractorVehicle Modifications