Provider Demographics
NPI:1013111806
Name:SCHLOMER, BRUCE JEREMY (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:JEREMY
Last Name:SCHLOMER
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 1:2350 N STEMMONS FWY
Mailing Address - Street 2:SUITE D-4300, MC F4.04
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-2700
Mailing Address - Country:US
Mailing Address - Phone:214-456-0646
Mailing Address - Fax:
Practice Address - Street 1:2350 N STEMMONS FWY
Practice Address - Street 2:SUITE D-4300, MC F4.04
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-2700
Practice Address - Country:US
Practice Address - Phone:214-456-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4817208800000X, 2088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX313524603Medicaid
269181YR9TMedicare PIN