Basic Information
Provider Information
NPI: 1982262259
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHROETER
FirstName: BARTON
MiddleName: LEE
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12508 JONES MALTSBERGER RD STE 110
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782474215
CountryCode: US
TelephoneNumber: 2105904000
FaxNumber: 2105904585
Practice Location
Address1: 8335 AGORA PKWY STE 100
Address2:  
City: SELMA
State: TX
PostalCode: 781541383
CountryCode: US
TelephoneNumber: 2106588483
FaxNumber: 2106580828
Other Information
ProviderEnumerationDate: 06/03/2019
LastUpdateDate: 06/03/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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