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General NPI Number Information
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NPI Number | 1609962661
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Entity Type | Organization
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Legal Business Name | CRISTY M SCHADE MD PA
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 2692 W WALNUT ST SUITE 105
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City | GARLAND
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State | TX
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Zip | 75042-6474
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Country | US
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Telephone | 972-494-2676
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Fax |
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Provider Business Mailing Address
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Address Line | 2692 W WALNUT ST SUITE 105
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City | GARLAND
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State | TX
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Zip | 75042-6474
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CRISTY MARK SCHADE
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Credential | MD
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Telephone | 972-494-2676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | F1971
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License Number State | TX
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