Provider Demographics
NPI:1699885459
Name:SCHMALSTIEG, ELISABETH JOAN (MD)
Entity type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:JOAN
Last Name:SCHMALSTIEG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6417 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-4017
Mailing Address - Country:US
Mailing Address - Phone:409-938-1077
Mailing Address - Fax:409-938-3876
Practice Address - Street 1:6417 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-4017
Practice Address - Country:US
Practice Address - Phone:409-938-1077
Practice Address - Fax:409-938-3876
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE11202084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX051003OtherPCA PROVIDER #
TXH32JOtherBCBS PROVIDER #
TX1278947Medicaid
TX00H32JMedicare ID - Type Unspecified
TX1278947Medicaid