Healthcare Provider Details

I. General information

NPI: 1578956140
Provider Name (Legal Business Name): SCHAAF ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2015
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 BALCONES DR SUITE 106
AUSTIN TX
78731-4252
US

IV. Provider business mailing address

5750 BALCONES DR SUITE 106
AUSTIN TX
78731-4252
US

V. Phone/Fax

Practice location:
  • Phone: 512-495-9015
  • Fax:
Mailing address:
  • Phone: 512-495-9015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberAC01595
License Number StateTX

VIII. Authorized Official

Name: WILL MITCHELL
Title or Position: VP
Credential:
Phone: 512-495-9015