Healthcare Provider Details

I. General information

NPI: 1477754885
Provider Name (Legal Business Name): ROBERT SKOLFIELD SCHMIDT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 05/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 EARL RUDDER FWY S
COLLEGE STATION TX
77845-6080
US

IV. Provider business mailing address

1630 WILKES RIDGE PARKWAY SUITE 104
RICHMOND VA
23233
US

V. Phone/Fax

Practice location:
  • Phone: 979-764-3090
  • Fax: 979-764-3172
Mailing address:
  • Phone: 804-762-0080
  • Fax: 804-762-0081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number0101246722
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: