Healthcare Provider Details

I. General information

NPI: 1427760453
Provider Name (Legal Business Name): MIA SCHNEIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2022
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8997 VANTAGE POINT DR
DALLAS TX
75243-3519
US

IV. Provider business mailing address

8997 VANTAGE POINT DR
DALLAS TX
75243-3519
US

V. Phone/Fax

Practice location:
  • Phone: 214-205-6794
  • Fax:
Mailing address:
  • Phone: 214-205-6794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number322703
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: