MEDICARE: VINITA B SCHROEDER, MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician	J4504	TX

General Provider Information

NPI Number	:	1689984478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VINITA B SCHROEDER, MD PA

Provider Business Mailing Address
First Line	:	4119 LOMO ALTO DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-1536
Country	:	US
Telephone Number	:	214-559-0202
Fax Number	:	214-559-0221

Provider Business Practice Location Address
First Line	:	4119 LOMO ALTO DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-1536
Country	:	US
Telephone Number	:	214-559-0202
Fax Number	:	214-559-0221

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VINITA SCHROEDER
Credential	:	MD
Telephone Number	:	214-559-0202

Provider Enumeration Date	:	10/14/2010
Last Update Date	:	10/14/2010

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