Provider Demographics
NPI:1528307949
Name:SCHMIDT, STACI ALICIA (PT)
Entity type:Individual
Prefix:MRS
First Name:STACI
Middle Name:ALICIA
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 WATERSIDE PL
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-5210
Mailing Address - Country:US
Mailing Address - Phone:214-208-4929
Mailing Address - Fax:
Practice Address - Street 1:7500 WATERSIDE PL
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-5210
Practice Address - Country:US
Practice Address - Phone:214-208-4929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1146857225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist