1396868253 NPI number — TINA K SCHUSTER DO

Table of content: TINA K SCHUSTER DO (NPI 1396868253)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396868253 NPI number — TINA K SCHUSTER DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHUSTER
Provider First Name:
TINA
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396868253
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6250 REGIONAL PLAZA
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
ABILENE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
325-428-5520
Provider Business Mailing Address Fax Number:
325-428-5529

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6250 REGIONAL PLAZA
Provider Second Line Business Practice Location Address:
SUITE 1010
Provider Business Practice Location Address City Name:
ABILENE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-428-5500
Provider Business Practice Location Address Fax Number:
325-428-5519
Provider Enumeration Date:
04/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  02006352A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X , with the licence number: 5101015372 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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