Provider Demographics
NPI:1366415416
Name:SCHLICHTEMEIER, ALVIN LEE (MD)
Entity type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:LEE
Last Name:SCHLICHTEMEIER
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:P.O. BOX 2289
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2289
Mailing Address - Country:US
Mailing Address - Phone:972-867-6916
Mailing Address - Fax:972-867-6916
Practice Address - Street 1:2215 E VILLA MARIA RD
Practice Address - Street 2:SUITE 130
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2548
Practice Address - Country:US
Practice Address - Phone:979-774-0808
Practice Address - Fax:979-776-3028
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF61072085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135743601Medicaid
TX135743601Medicaid
TX83R956Medicare ID - Type Unspecified