Provider Demographics
NPI:1396919551
Name:STEPHEN A. SCHULMAN
Entity type:Organization
Organization Name:STEPHEN A. SCHULMAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SCHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-382-9448
Mailing Address - Street 1:2501 SCRIPTURE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2314
Mailing Address - Country:US
Mailing Address - Phone:940-382-9448
Mailing Address - Fax:940-382-7509
Practice Address - Street 1:2501 SCRIPTURE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2314
Practice Address - Country:US
Practice Address - Phone:940-382-9448
Practice Address - Fax:940-382-7509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121507103Medicaid