Provider Demographics
NPI:1831275429
Name:SCHMIDT, TROY DON (MD)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:DON
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35629
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0629
Mailing Address - Country:US
Mailing Address - Phone:214-424-2200
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:505 S NOLEN DR
Practice Address - Street 2:SUITE A
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-9167
Practice Address - Country:US
Practice Address - Phone:817-424-1525
Practice Address - Fax:817-424-3491
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5925207R00000X, 207RG0100X
TXQ4841207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ4841OtherTEXAS MEDICAL LICENSE
H78848Medicare UPIN
SDS101328Medicare PIN
TXQ4841OtherTEXAS MEDICAL LICENSE