Healthcare Provider Details

I. General information

NPI: 1326342742
Provider Name (Legal Business Name): MICHAEL R. SCHLABACH, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 BANDERA HWY SUITE 1-B
KERRVILLE TX
78028-9515
US

IV. Provider business mailing address

1331 BANDERA HWY SUITE 1-B
KERRVILLE TX
78028-9515
US

V. Phone/Fax

Practice location:
  • Phone: 830-792-2118
  • Fax: 830-792-2131
Mailing address:
  • Phone: 830-792-2118
  • Fax: 830-792-2131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberF1974
License Number StateTX

VIII. Authorized Official

Name: DR. MICHAEL RAY SCHLABACH SR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 830-792-2118