Provider Demographics
NPI:1740735562
Name:SCHNEIDER, BENJAMIN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15210 INTERSTATE 45 S
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4105
Mailing Address - Country:US
Mailing Address - Phone:832-702-7272
Mailing Address - Fax:832-702-7255
Practice Address - Street 1:15210 INTERSTATE 45 S
Practice Address - Street 2:SUITE 108
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-4105
Practice Address - Country:US
Practice Address - Phone:832-702-7272
Practice Address - Fax:832-702-7255
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1280250225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist