Provider Demographics
NPI:1508083924
Name:DAVID W SCHATZ
Entity Type:Organization
Organization Name:DAVID W SCHATZ
Other - Org Name:CITY DRUG CO.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SCHATZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:903-482-5279
Mailing Address - Street 1:PO BOX 337
Mailing Address - Street 2:
Mailing Address - City:VAN ALSTYNE
Mailing Address - State:TX
Mailing Address - Zip Code:75495-0337
Mailing Address - Country:US
Mailing Address - Phone:903-482-5279
Mailing Address - Fax:903-482-6851
Practice Address - Street 1:209 EAST JEFFERSON ST.
Practice Address - Street 2:
Practice Address - City:VAN ALSTYNE
Practice Address - State:TX
Practice Address - Zip Code:75495-0337
Practice Address - Country:US
Practice Address - Phone:903-482-5279
Practice Address - Fax:903-482-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX157583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143917Medicaid
TX4533027OtherNCPDP
TX4533027OtherNCPDP