Provider Demographics
NPI:1710055629
Name:SCHAROLD SERVICES ASSOCIATION
Entity Type:Organization
Organization Name:SCHAROLD SERVICES ASSOCIATION
Other - Org Name:MARY L. SCHAROLD, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SCHAROLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-992-0315
Mailing Address - Street 1:1406 E MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-5343
Mailing Address - Country:US
Mailing Address - Phone:830-992-0315
Mailing Address - Fax:
Practice Address - Street 1:150 E MAIN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4228
Practice Address - Country:US
Practice Address - Phone:830-992-0315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD51012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00RD06OtherUPIN