Healthcare Provider Details

I. General information

NPI: 1902530835
Provider Name (Legal Business Name): ROBERT HALE SCHMIDT PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2022
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11335 SSG SIMS ST
FT BLISS TX
79918
US

IV. Provider business mailing address

11335 SSG SIMS ST
FT BLISS TX
79918
US

V. Phone/Fax

Practice location:
  • Phone: 915-742-2121
  • Fax:
Mailing address:
  • Phone: 157-422-2739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA15992
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: