Provider Demographics
NPI:1760441604
Name:GOLDSCHMIEDT, MARKUS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARKUS
Middle Name:
Last Name:GOLDSCHMIEDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7208
Mailing Address - Country:US
Mailing Address - Phone:214-645-0575
Mailing Address - Fax:
Practice Address - Street 1:1801 INWOOD ROAD 6TH FL STE 6.102
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-3311
Practice Address - Country:US
Practice Address - Phone:214-645-0575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3471207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118057201Medicaid
TX82Z560OtherBCBSTX
TXE94567Medicare UPIN
TX118057201Medicaid
TX110127239Medicare PIN