Provider Demographics
NPI:1871501395
Name:SCHMIDT, INGRID ELISABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:INGRID
Middle Name:ELISABETH
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 BALCONES DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4252
Mailing Address - Country:US
Mailing Address - Phone:512-453-2755
Mailing Address - Fax:512-451-6779
Practice Address - Street 1:5750 BALCONES DR
Practice Address - Street 2:SUITE 109
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4252
Practice Address - Country:US
Practice Address - Phone:512-453-2755
Practice Address - Fax:512-451-6779
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE46632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
741997574OtherFEDERAL TAX ID
00AJ78OtherBCBS
TX00AJ78Medicare PIN
B88071Medicare UPIN
00AJ78Medicare ID - Type Unspecified