Provider Demographics
NPI:1760568588
Name:SCHROEDER, LORRAINE K (MD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:K
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 WELLS BRANCH PKWY STE 113
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-6904
Mailing Address - Country:US
Mailing Address - Phone:512-251-2828
Mailing Address - Fax:512-251-6615
Practice Address - Street 1:2013 WELLS BRANCH PKWY STE 113
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-6904
Practice Address - Country:US
Practice Address - Phone:512-251-2828
Practice Address - Fax:512-251-6615
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0796207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00048MMedicare PIN
TXB88125Medicare UPIN