Provider Demographics
NPI:1417046467
Name:SCHULTZE, HARRY MARTIN JR (DC)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:MARTIN
Last Name:SCHULTZE
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 S INTERSTATE 35
Mailing Address - Street 2:STE 170
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-7912
Mailing Address - Country:US
Mailing Address - Phone:512-252-3030
Mailing Address - Fax:512-252-3673
Practice Address - Street 1:2400 S INTERSTATE 35
Practice Address - Street 2:STE 170
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-7912
Practice Address - Country:US
Practice Address - Phone:512-252-3030
Practice Address - Fax:512-252-3673
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9777111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV02937Medicare UPIN
TX611282Medicare ID - Type Unspecified