Provider Demographics
NPI:1740800234
Name:SCHWARZ, HAYDEN JEFFRY
Entity Type:Individual
Prefix:
First Name:HAYDEN
Middle Name:JEFFRY
Last Name:SCHWARZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:837 CLUBS DR
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-0319
Mailing Address - Country:US
Mailing Address - Phone:713-557-9557
Mailing Address - Fax:
Practice Address - Street 1:116 W BLANCO RD STE 9
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2093
Practice Address - Country:US
Practice Address - Phone:830-816-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-20-116217106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician