Provider Demographics
NPI:1306485974
Name:SCHMALZ, JONATHAN EDWIN (PHD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:EDWIN
Last Name:SCHMALZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13807 PLACID BROOK CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3409
Mailing Address - Country:US
Mailing Address - Phone:281-744-1275
Mailing Address - Fax:
Practice Address - Street 1:2700 BAY AREA BLVD
Practice Address - Street 2:SSCB 3103
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058
Practice Address - Country:US
Practice Address - Phone:281-283-2586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37105103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical