Provider Demographics
NPI:1467528083
Name:SCHULZE, RANDALL M (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:M
Last Name:SCHULZE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11924 VANCE JACKSON
Mailing Address - Street 2:STE 104
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230
Mailing Address - Country:US
Mailing Address - Phone:210-696-5150
Mailing Address - Fax:210-696-3556
Practice Address - Street 1:11924 VANCE JACKSON
Practice Address - Street 2:STE 104
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1459
Practice Address - Country:US
Practice Address - Phone:210-696-5150
Practice Address - Fax:210-696-3556
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD4512111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001355901Medicaid
TX89M376Medicare PIN