Provider Demographics
NPI:1477864635
Name:BRIAN E SCHULZE MD PA
Entity Type:Organization
Organization Name:BRIAN E SCHULZE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ODOWD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-477-5151
Mailing Address - Street 1:12709 TOEPPERWEIN RD
Mailing Address - Street 2:STE 101
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3259
Mailing Address - Country:US
Mailing Address - Phone:210-477-5151
Mailing Address - Fax:210-477-5162
Practice Address - Street 1:12709 TOEPPERWEIN RD
Practice Address - Street 2:STE 101
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3259
Practice Address - Country:US
Practice Address - Phone:210-477-5151
Practice Address - Fax:210-477-5162
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIAN E SCHULZE MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty