Provider Demographics
NPI:1063499416
Name:SCHNEIDER, MARTIN L (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:L
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 S SONCY RD
Mailing Address - Street 2:STE 140
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6407
Mailing Address - Country:US
Mailing Address - Phone:806-355-5625
Mailing Address - Fax:806-352-2245
Practice Address - Street 1:3501 S SONCY RD
Practice Address - Street 2:STE 140
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6407
Practice Address - Country:US
Practice Address - Phone:806-355-5625
Practice Address - Fax:806-352-2245
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE0289207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX040017693OtherRR MEDICARE
TX123443103OtherFIRSTCARE/SWHEALTHLIFE
TX8H0732OtherBCBS
TX110275804Medicaid
TX123443103OtherFIRSTCARE/SWHEALTHLIFE
TXB88094Medicare UPIN