Provider Demographics
NPI:1669414959
Name:SCHADE, CYNTHIA J (DC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:SCHADE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 MOZELLE LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-8032
Mailing Address - Country:US
Mailing Address - Phone:512-474-5433
Mailing Address - Fax:
Practice Address - Street 1:1315 W 6TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-5210
Practice Address - Country:US
Practice Address - Phone:512-474-5433
Practice Address - Fax:512-469-0717
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX603437Medicare ID - Type Unspecified
T85503Medicare UPIN