Provider Demographics
NPI:1699199273
Name:SCHULTZ, NANCY (PHD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7330 STONEBRIDGE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4098
Mailing Address - Country:US
Mailing Address - Phone:281-458-9974
Mailing Address - Fax:281-458-9974
Practice Address - Street 1:7330 STONEBRIDGE CREEK LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4098
Practice Address - Country:US
Practice Address - Phone:281-458-9974
Practice Address - Fax:281-458-9974
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30858103TB0200X
TX30765103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX30858OtherLICENSE
TX30765OtherLICENSE