Provider Demographics
NPI:1427041557
Name:SCHWARTZ, MICHAEL S (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4031 W PLANO PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5617
Mailing Address - Country:US
Mailing Address - Phone:972-985-1072
Mailing Address - Fax:972-964-3469
Practice Address - Street 1:4031 W PLANO PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5617
Practice Address - Country:US
Practice Address - Phone:972-985-1072
Practice Address - Fax:972-964-3469
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3848207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CR149OtherBCBS TX 02/01/2011
TX046482801Medicaid
TXTXB117558OtherMEDICARE PART B - EFFECT 02/01/2011
TXP00913337OtherMEDICARE RAILROAD - EFFECT 02/01/2011
TXG69384Medicare UPIN
TX046482801Medicaid
TXP00913337OtherMEDICARE RAILROAD - EFFECT 02/01/2011
TX8CR149OtherBCBS TX 02/01/2011