Provider Demographics
NPI:1811001423
Name:SCHNEIDER, REBECCA M (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:M
Other - Last Name:STAGGEMEIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8479 US HIGHWAY 96 S
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-6943
Mailing Address - Country:US
Mailing Address - Phone:409-594-0255
Mailing Address - Fax:251-260-8205
Practice Address - Street 1:1276 S PEACHTREE ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4916
Practice Address - Country:US
Practice Address - Phone:409-384-5701
Practice Address - Fax:409-384-4238
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0626207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11609956OtherCAQH NUMBER
TX175390702Medicaid
11609956OtherCAQH NUMBER
I35312Medicare UPIN