Provider Demographics
NPI:1497067839
Name:SCHATZ, RAY LEROY III (IDMT)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:LEROY
Last Name:SCHATZ
Suffix:III
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 N TORCH BLVD
Mailing Address - Street 2:
Mailing Address - City:CANNON AFB
Mailing Address - State:NM
Mailing Address - Zip Code:88103-5109
Mailing Address - Country:US
Mailing Address - Phone:575-784-0287
Mailing Address - Fax:
Practice Address - Street 1:511 N TORCH BLVD
Practice Address - Street 2:
Practice Address - City:CANNON AFB
Practice Address - State:NM
Practice Address - Zip Code:88103-5109
Practice Address - Country:US
Practice Address - Phone:575-784-0287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians