Healthcare Provider Details

I. General information

NPI: 1912815812
Provider Name (Legal Business Name): GAGE SCHREIBER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 E 29TH ST N
WICHITA KS
67226-2169
US

IV. Provider business mailing address

11733 PEBBLESTONE LN APT 31
WICHITA KS
67226-7217
US

V. Phone/Fax

Practice location:
  • Phone: 316-634-8710
  • Fax: 316-634-8891
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: