Provider Demographics
NPI:1659464733
Name:SCHARTZ, TERESA B (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:B
Last Name:SCHARTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:801 7TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2733
Practice Address - Country:US
Practice Address - Phone:682-885-4054
Practice Address - Fax:682-885-7497
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8272207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115291100OtherFIRSTCARE PIN
TX00N47FOtherBCBSTX GRP PIN
TX100772OtherSUPERIOR PIN
TX126522506Medicaid
TX4644752OtherAETNA PIN
TX126522504Medicaid
TX137345809Medicaid
1447220850OtherGRP NPI NUMBER
TX1296525OtherUHC PIN
TX295509OtherPHCS PIN
TX842677OtherFIRSTHEALTH PIN
TX10032311OtherAMERIGROUP PIN
TX140442853Medicaid
TX7950641OtherCIGNA PIN
TX88412YOtherBCBSTX IND PIN
TX137345809Medicaid
TX8645J3Medicare PIN
TX115291100OtherFIRSTCARE PIN