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NPI Code Detail

MEDICARE: JAKE WILLIAM SCHROETER CST

MEDICARE: JAKE WILLIAM SCHROETER CST
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
1156F00000XTechnician/Technologist131022TX

General Provider Information

NPI Number : 1588520001
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAKE WILLIAM SCHROETER CST
Provider Business Mailing Address
First Line : 15531 ECORIO DR
Second Line :
City : AUSTIN
State : TX
Zip : 78728-3542
Country : US
Telephone Number : 409-719-6851
Fax Number :
Provider Business Practice Location Address
First Line : 1201 W 38TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1006
Country : US
Telephone Number : 512-324-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2025
Last Update Date : 12/29/2025

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Directions to “ JAKE WILLIAM SCHROETER CST” Practice Location

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