Provider Demographics
NPI:1437102159
Name:SCHONERT, BECKY H (PNP)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:H
Last Name:SCHONERT
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8515 GREENVILLE AVE STE N108
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-7035
Mailing Address - Country:US
Mailing Address - Phone:214-221-0855
Mailing Address - Fax:214-221-1437
Practice Address - Street 1:5750 PINELAND DR # 260
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5300
Practice Address - Country:US
Practice Address - Phone:469-637-4204
Practice Address - Fax:214-221-0855
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX617705363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178828301Medicaid