Provider Demographics
NPI:1780800664
Name:SCHWARTZ, BURTON W (MD)
Entity type:Individual
Prefix:DR
First Name:BURTON
Middle Name:W
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:TCU PO BOX 297400
Mailing Address - Street 2:BROWN LUPTON STUDENT HEALTH CENTER
Mailing Address - City:FORTWORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76129
Mailing Address - Country:US
Mailing Address - Phone:817-257-7940
Mailing Address - Fax:817-257-7279
Practice Address - Street 1:2825 STADIUM DRIVE
Practice Address - Street 2:BROWN LUPTON HEALTH CENTER TCU
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109
Practice Address - Country:US
Practice Address - Phone:817-257-7940
Practice Address - Fax:817-257-7279
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE1410208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E1410Medicare UPIN