Provider Demographics
NPI:1497370639
Name:SCHOLL, PATRICK DENNIS
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:DENNIS
Last Name:SCHOLL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 BACKTRAIL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-2668
Mailing Address - Country:US
Mailing Address - Phone:512-565-3847
Mailing Address - Fax:
Practice Address - Street 1:5039 HAMILTON WOLFE RD APT 3402
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-0019
Practice Address - Country:US
Practice Address - Phone:512-565-3847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-13
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX39152122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program