MEDICARE: MRS. STACI ALICIA SCHMIDT PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1146857	TX

General Provider Information

NPI Number	:	1528307949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STACI ALICIA SCHMIDT PT

Provider Business Mailing Address
First Line	:	7500 WATERSIDE PL
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-5210
Country	:	US
Telephone Number	:	214-208-4929
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 WATERSIDE PL
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-5210
Country	:	US
Telephone Number	:	214-208-4929
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2013
Last Update Date	:	02/05/2013

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