1780786913 NPI number — JOHN P SCHNATZ FNP

Table of content: JOHN P SCHNATZ FNP (NPI 1780786913)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780786913 NPI number — JOHN P SCHNATZ FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHNATZ
Provider First Name:
JOHN
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
M

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:
1780786913
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 S COULTER ST STE 413
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMARILLO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79106-1766
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-677-7952
Provider Business Mailing Address Fax Number:
806-353-6081

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
705 QUAIL CREEK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMARILLO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79124-1608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-353-6400
Provider Business Practice Location Address Fax Number:
806-358-2662
Provider Enumeration Date:
09/01/2006

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: 363LF0000X , with the licence number:  463295 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: AP108182 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 287901701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200402120 A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 287901702 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 68487070 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




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