Provider Demographics
NPI:1881834166
Name:SCHOTT, BRIAN ROBERT
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:ROBERT
Last Name:SCHOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 BULL RUN TRL
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-9723
Mailing Address - Country:US
Mailing Address - Phone:903-295-1468
Mailing Address - Fax:
Practice Address - Street 1:2901 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5128
Practice Address - Country:US
Practice Address - Phone:903-758-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX080748367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8777UKOtherBCBS
705810OtherTEXAS STATE BOARD OF NURSING
TX080748OtherCOUNCIL OF CERTIFICATION OF NURSE ANESTHETISTS
TX75-0818167-015OtherTRICARE
TX080748OtherCOUNCIL OF CERTIFICATION OF NURSE ANESTHETISTS