Provider Demographics
NPI:1780640979
Name:SCHMIDT, HOWARD RANDALL (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:RANDALL
Last Name:SCHMIDT
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 1:919 HIDDEN RDG
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3813
Mailing Address - Country:US
Mailing Address - Phone:469-282-2711
Mailing Address - Fax:469-282-0996
Practice Address - Street 1:1920 GALLERIA OAKS DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-4619
Practice Address - Country:US
Practice Address - Phone:903-792-6114
Practice Address - Fax:903-792-7876
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5627208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100070640AMedicaid
AR115944001Medicaid
TX105270606Medicaid
TX105270604Medicaid
TXB65898Medicare UPIN