Provider Demographics
NPI:1851739569
Name:SCHWALK, AUDRA JANE (MD)
Entity Type:Individual
Prefix:
First Name:AUDRA
Middle Name:JANE
Last Name:SCHWALK
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: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:214-645-6616
Mailing Address - Fax:
Practice Address - Street 1:5939 HARRY HINES BLVD 9TH FLOOR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-0002
Practice Address - Country:US
Practice Address - Phone:214-645-6616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6939207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease