Provider Demographics
NPI:1235532607
Name:SCHILDT, STEPHANIE ANNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ANNE
Last Name:SCHILDT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 OHIO DR
Mailing Address - Street 2:SUITE 133
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3927
Mailing Address - Country:US
Mailing Address - Phone:972-398-7881
Mailing Address - Fax:
Practice Address - Street 1:2301 OHIO DR
Practice Address - Street 2:SUITE 133
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3927
Practice Address - Country:US
Practice Address - Phone:972-398-7881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1233209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist