1932713195 NPI number — AMY MARIE-LUCERO SCHOENFELD PHYSICAL THERAPIST

Table of content: AMY MARIE-LUCERO SCHOENFELD PHYSICAL THERAPIST (NPI 1932713195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932713195 NPI number — AMY MARIE-LUCERO SCHOENFELD PHYSICAL THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHOENFELD
Provider First Name:
AMY
Provider Middle Name:
MARIE-LUCERO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LUCERO
Provider Other First Name:
AMY
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932713195
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 932184
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31193-2184
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-699-9395
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
151 STAGECOACH TRL STE 230
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN MARCOS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78666-3863
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-214-8202
Provider Business Practice Location Address Fax Number:
512-214-8061
Provider Enumeration Date:
09/04/2020

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: 225100000X , with the licence number:  1334397 , 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)





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