Provider Demographics
NPI:1093712531
Name:SCHUSSLER, IRWIN (DO)
Entity Type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:
Last Name:SCHUSSLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 W 38TH ST STE 53
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6320
Mailing Address - Country:US
Mailing Address - Phone:512-377-2500
Mailing Address - Fax:512-377-2501
Practice Address - Street 1:1500 W 38TH ST STE 53
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6320
Practice Address - Country:US
Practice Address - Phone:512-377-2500
Practice Address - Fax:512-377-2501
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9882103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX034232102Medicaid
8263NOMedicare ID - Type Unspecified