Provider Demographics
NPI:1316974140
Name:SCHMIDT, SARA A (DC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6109 MELODY LN
Mailing Address - Street 2:
Mailing Address - City:WATAUGA
Mailing Address - State:TX
Mailing Address - Zip Code:76148-3618
Mailing Address - Country:US
Mailing Address - Phone:817-845-2644
Mailing Address - Fax:
Practice Address - Street 1:3307 BELT LINE RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-6913
Practice Address - Country:US
Practice Address - Phone:972-496-2225
Practice Address - Fax:972-495-3531
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8377111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U3302OtherBCBS
TX8R1726OtherBCBS
TX8G5336Medicare ID - Type Unspecified