Provider Demographics
NPI:1891742854
Name:SCHLOTTER, JAMES WALLACE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WALLACE
Last Name:SCHLOTTER
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 1:1602 E HOUSTON HWY STE A
Mailing Address - Street 2:
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102
Mailing Address - Country:US
Mailing Address - Phone:361-354-2832
Mailing Address - Fax:
Practice Address - Street 1:1602 E HOUSTON HWY STE A
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102
Practice Address - Country:US
Practice Address - Phone:361-354-2832
Practice Address - Fax:361-354-2884
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG00742086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033809701Medicaid
E10657Medicare UPIN
TXSC000H91PMedicare ID - Type Unspecified