Provider Demographics
NPI:1184030652
Name:SCHNEIDER, VIVIAN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 TROUP HWY
Mailing Address - Street 2:120
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-8397
Mailing Address - Country:US
Mailing Address - Phone:903-509-3742
Mailing Address - Fax:
Practice Address - Street 1:2006 STERLING DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-5819
Practice Address - Country:US
Practice Address - Phone:903-533-1728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-06
Last Update Date:2014-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2018800251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health