Provider Demographics
NPI:1912014812
Name:SCHAEFER, JESSICA MARIE (DO)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JESSICAN
Other - Middle Name:MARIE
Other - Last Name:BREIDENSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8715 VILLAGE DR
Mailing Address - Street 2:STE 400
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5405
Mailing Address - Country:US
Mailing Address - Phone:210-732-3668
Mailing Address - Fax:210-732-3338
Practice Address - Street 1:8715 VILLAGE DR
Practice Address - Street 2:STE 400
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5405
Practice Address - Country:US
Practice Address - Phone:210-732-3668
Practice Address - Fax:210-732-3338
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8978207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB158009OtherWELLMED NETWORKS INC
510007YMVUOtherWELLMED NETWORKS INC