Provider Demographics
NPI:1083797799
Name:SCHNELL, KENT D (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:D
Last Name:SCHNELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5030 CRENSHAW RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3140
Mailing Address - Country:US
Mailing Address - Phone:713-941-3798
Mailing Address - Fax:713-943-7481
Practice Address - Street 1:5030 CRENSHAW RD
Practice Address - Street 2:SUITE 120
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3140
Practice Address - Country:US
Practice Address - Phone:713-941-3798
Practice Address - Fax:713-943-7481
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8477207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX043003501Medicaid
G69880Medicare UPIN
TX84412KMedicare ID - Type Unspecified