Healthcare Provider Details

I. General information

NPI: 1508818949
Provider Name (Legal Business Name): JEFFREY STEPHEN SCHLAB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W 38TH ST
AUSTIN TX
78705-1006
US

IV. Provider business mailing address

5832 GORHAM GLEN LN
AUSTIN TX
78739-1801
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-1010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberK8476
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: