Provider Demographics
NPI:1801998091
Name:SCHWARTZ, NELL (PHD)
Entity type:Individual
Prefix:DR
First Name:NELL
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:NELL
Other - Middle Name:
Other - Last Name:SISTRUNK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:6977 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3701
Mailing Address - Country:US
Mailing Address - Phone:713-797-1616
Mailing Address - Fax:713-793-3779
Practice Address - Street 1:6977 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3701
Practice Address - Country:US
Practice Address - Phone:713-797-1616
Practice Address - Fax:713-793-3779
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24074103TC0700X, 103T00000X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115359502Medicaid
TX115359503Medicaid
TN00L06NOtherBCBS PROVIDER NUMBER