Provider Demographics
NPI:1962444810
Name:SCHACHNER, JAY REGGIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:REGGIE
Last Name:SCHACHNER
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:690 N 14TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1449
Practice Address - Country:US
Practice Address - Phone:409-899-7180
Practice Address - Fax:409-899-7186
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9530207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137522201Medicaid
TX137522205Medicaid
TX137522203Medicaid
TX137522207Medicaid
TX8R1544OtherBLUE CROSS OF TEXAS
TX137522202Medicaid
TX137522206Medicaid
TX137522211Medicaid
TX87772KMedicare PIN
TX137522201Medicaid
TX89X561Medicare PIN
TX8K8614Medicare PIN
TX900002994Medicare PIN
TX521576YZ21Medicare PIN