=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538783386
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. GINGER SCHIRMER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/07/2020
-----------------------------------------------------
Last Update Date | 06/07/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3232 WESTMINSTER AVE
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75205-1427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-629-2047
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3232 WESTMINSTER AVE
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75205-1427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-629-2047
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133N00000X
-----------------------------------------------------
Taxonomy Name | Nutritionist
-----------------------------------------------------
License Number | 712041
-----------------------------------------------------
License Number State |
-----------------------------------------------------