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General NPI Number Information
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NPI Number | 1659309441
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Entity Type | Organization
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Legal Business Name | HEIDI SCHULTZ, M.D., P.A.
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 7629 TIKI DR
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City | FULSHEAR
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State | TX
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Zip | 77441-1548
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Country | US
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Telephone | 281-346-0018
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Fax | 281-346-0913
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Provider Business Mailing Address
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Address Line | 600 JEFFERSON ST STE 404
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City | LAFAYETTE
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State | LA
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Zip | 70501-6991
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Country | US
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Telephone | 281-346-0018
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Fax | 281-346-0913
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Authorized Official
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Title or Position | OWNER
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Name | ANISHA WAXALI
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Credential | MD
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Telephone | 281-346-0018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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