Provider Demographics
NPI:1972792315
Name:MICHAEL D. TSCHOEPE, M.D., P.A.
Entity Type:Organization
Organization Name:MICHAEL D. TSCHOEPE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:TSCHOEPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-625-6905
Mailing Address - Street 1:218 E AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4106
Mailing Address - Country:US
Mailing Address - Phone:830-625-6905
Mailing Address - Fax:830-620-4822
Practice Address - Street 1:218 E AUSTIN ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4106
Practice Address - Country:US
Practice Address - Phone:830-625-6905
Practice Address - Fax:830-620-4822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6660207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085241001Medicaid
TX88X930OtherBLUE CROSS BLUE SHIELD
TX88X930OtherBLUE CROSS BLUE SHIELD