Provider Demographics
NPI:1750498994
Name:SCHWABE, DONNA G (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:G
Last Name:SCHWABE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RANDOLPH MENTAL HEALTH CLINIC
Mailing Address - Street 2:221 3RD ST. W, BLDG 1040
Mailing Address - City:JBSA-RANDOLPH
Mailing Address - State:TX
Mailing Address - Zip Code:78150
Mailing Address - Country:US
Mailing Address - Phone:210-652-2448
Mailing Address - Fax:
Practice Address - Street 1:221 3RD ST W BLDG 1040
Practice Address - Street 2:
Practice Address - City:JBSA RANDOLPH
Practice Address - State:TX
Practice Address - Zip Code:78150-4800
Practice Address - Country:US
Practice Address - Phone:210-652-2448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003262103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA288974OtherANTHEM BCBS
VA508378OtherVALUE OPTIONS
VA010016720Medicaid
VA284232000OtherMAGELLAN
VA010016720Medicaid