Provider Demographics
NPI:1922001288
Name:SCHULZ, MARK D (DC, CCN, DABCN)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:SCHULZ
Suffix:
Gender:M
Credentials:DC, CCN, DABCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13203 QUIET LAKE LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5581
Mailing Address - Country:US
Mailing Address - Phone:713-557-1013
Mailing Address - Fax:866-886-2294
Practice Address - Street 1:13203 QUIET LAKE LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5581
Practice Address - Country:US
Practice Address - Phone:713-557-1013
Practice Address - Fax:866-886-2294
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6112111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605509OtherBLUE CROSS BLUE SHEILD
TX605509Medicare ID - Type Unspecified