Provider Demographics
NPI:1366470221
Name:SCHOONMAKER, JOHN BULLARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BULLARD
Last Name:SCHOONMAKER
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 1:25325 BOROUGH PARK DR
Mailing Address - Street 2:STE 200
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3569
Mailing Address - Country:US
Mailing Address - Phone:281-364-0155
Mailing Address - Fax:281-419-3036
Practice Address - Street 1:25325 BOROUGH PARK DR
Practice Address - Street 2:STE 200
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3569
Practice Address - Country:US
Practice Address - Phone:281-364-0155
Practice Address - Fax:281-419-3036
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG20172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132079808Medicaid
TX132079808Medicaid