Healthcare Provider Details

I. General information

NPI: 1952734758
Provider Name (Legal Business Name): SCHAFER MEDICAL HOME VISITS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2013
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 HERITAGE DR SUITE 110
MCKINNEY TX
75069-3256
US

IV. Provider business mailing address

1515 HERITAGE DR SUITE 110
MCKINNEY TX
75069-3256
US

V. Phone/Fax

Practice location:
  • Phone: 855-860-2109
  • Fax: 855-814-8428
Mailing address:
  • Phone: 855-860-2109
  • Fax: 855-814-8428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH0790
License Number StateTX

VIII. Authorized Official

Name: SUZANNE SCHAFER
Title or Position: OWNER/ PRESIDENT
Credential: DO
Phone: 855-860-2109