Provider Demographics
NPI:1487847141
Name:SHARI ROSEN-SCHMIDT,MD,PA
Entity type:Organization
Organization Name:SHARI ROSEN-SCHMIDT,MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEN-SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-403-3100
Mailing Address - Street 1:6124 W.PARKER RD
Mailing Address - Street 2:SUITE #336
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5993
Mailing Address - Country:US
Mailing Address - Phone:972-403-3100
Mailing Address - Fax:972-403-3105
Practice Address - Street 1:6124 W PARKER RD
Practice Address - Street 2:SUITE #336
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8122
Practice Address - Country:US
Practice Address - Phone:972-403-3100
Practice Address - Fax:972-403-3105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7880174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0005MTOtherBLUE CROSS BLUE SHIELD
TX8F0900OtherMEDICARE ID #
TX000341ZMedicare PIN