Provider Demographics
NPI:1245768548
Name:SCHUBERT, ALFRED WILLIAM IV (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:WILLIAM
Last Name:SCHUBERT
Suffix:IV
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 E FM 628
Mailing Address - Street 2:
Mailing Address - City:RIVIERA
Mailing Address - State:TX
Mailing Address - Zip Code:78379-3585
Mailing Address - Country:US
Mailing Address - Phone:361-726-6252
Mailing Address - Fax:
Practice Address - Street 1:1001 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2833
Practice Address - Country:US
Practice Address - Phone:361-853-0488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12945052251P0200X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist