Provider Demographics
NPI:1497960496
Name:SCHAFFER, LILLY HELENE (MD)
Entity Type:Individual
Prefix:
First Name:LILLY
Middle Name:HELENE
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3604 PRESTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8629
Mailing Address - Country:US
Mailing Address - Phone:972-867-3399
Mailing Address - Fax:972-596-4740
Practice Address - Street 1:3604 PRESTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8629
Practice Address - Country:US
Practice Address - Phone:972-867-3399
Practice Address - Fax:972-596-4740
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6295207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1568679942OtherBILLING NPI
TXG74533Medicare UPIN