Provider Demographics
NPI:1336411578
Name:MATTHEW BLEU SCHNIEDERJAN MD PLLC
Entity Type:Organization
Organization Name:MATTHEW BLEU SCHNIEDERJAN MD PLLC
Other - Org Name:PANHANDLE WEIGHT LOSS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-677-7952
Mailing Address - Street 1:1301 S COULTER ST STE 413
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1763
Mailing Address - Country:US
Mailing Address - Phone:806-677-7952
Mailing Address - Fax:806-353-6081
Practice Address - Street 1:1301 S COULTER ST STE 413
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1763
Practice Address - Country:US
Practice Address - Phone:806-677-7952
Practice Address - Fax:806-353-6081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5515261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center