Basic Information
Provider Information
NPI: 1568767804
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHMIEDER
FirstName: MONICA
MiddleName: FOSTER
NamePrefix:  
NameSuffix:  
Credential: CPO,LPO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752845347
CountryCode: US
TelephoneNumber: 2146450334
FaxNumber: 2146450078
Practice Location
Address1: 5323 HARRY HINES BLVD
Address2:  
City: DALLAS
State: TX
PostalCode: 753907208
CountryCode: US
TelephoneNumber: 2146450334
FaxNumber: 2146450078
Other Information
ProviderEnumerationDate: 01/18/2011
LastUpdateDate: 05/25/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
222Z00000X1429TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist 
224P00000X1429TXN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist 

No ID Information.


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