Provider Demographics
NPI:1720059504
Name:SCHOLL, PETER D (DDS,MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:D
Last Name:SCHOLL
Suffix:
Gender:M
Credentials:DDS,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 WYOMING SPRINGS DR STE 1400
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4306
Mailing Address - Country:US
Mailing Address - Phone:512-458-6391
Mailing Address - Fax:512-580-0097
Practice Address - Street 1:7200 WYOMING SPRINGS DR STE 1400
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4306
Practice Address - Country:US
Practice Address - Phone:512-458-6391
Practice Address - Fax:512-580-0097
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0078207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4260748OtherAETNA
TXG0078OtherSTATE LICENSE
TX83C682OtherBCBS
TXG0078OtherSTATE LICENSE
TX4260748OtherAETNA
TXB21386Medicare UPIN