Provider Demographics
NPI:1134226673
Name:SCHNEIDER, LAWRENCE JOSEPH (PHD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:JOSEPH
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 RIDGECREST CIR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-5421
Mailing Address - Country:US
Mailing Address - Phone:940-383-2043
Mailing Address - Fax:
Practice Address - Street 1:725 W PURNELL RD
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4555
Practice Address - Country:US
Practice Address - Phone:972-436-9311
Practice Address - Fax:800-819-1655
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-1039103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113518801Medicaid
TX86084AOtherBCBS
TX113518801Medicaid