MEDICARE: VINITA SCHROEDER M.D.

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	:	1750498713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINITA SCHROEDER M.D.

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	09/10/2024

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