Healthcare Provider Details

I. General information

NPI: 1205859246
Provider Name (Legal Business Name): ROBERT LESLIE SCHREINER P.A.,C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 HIGHWAY 71 W SUITE C
BASTROP TX
78602-3931
US

IV. Provider business mailing address

441 HIGHWAY 71 W SUITE C
BASTROP TX
78602-3931
US

V. Phone/Fax

Practice location:
  • Phone: 512-360-3698
  • Fax: 512-237-5768
Mailing address:
  • Phone: 512-360-3698
  • Fax: 512-237-5768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA00408
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: