Provider Demographics
NPI:1760412738
Name:SCHUELLER, JULIE ANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:SCHUELLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4129 CAMACHO ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-5388
Mailing Address - Country:US
Mailing Address - Phone:919-423-0565
Mailing Address - Fax:
Practice Address - Street 1:117-B LOUIS HENNA BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664
Practice Address - Country:US
Practice Address - Phone:512-255-9634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001000443363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC001000443OtherNC STATE LICENSE NUMBER
TXPA07241OtherTEXAS LICENSE
TXPA07241OtherTEXAS LICENSE