MEDICARE: ANNA FAYE SCHOEPHOERSTER

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	171M00000X	Case Manager/Care Coordinator	0000000000	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19628615	OTHER	TX	NATIONAL PRODUCER NUMBER

General Provider Information

NPI Number	:	1639838022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA FAYE SCHOEPHOERSTER

Provider Business Mailing Address
First Line	:	3624 EL CAMPO AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-4511
Country	:	US
Telephone Number	:	281-435-3160
Fax Number	:

Provider Business Practice Location Address
First Line	:	3624 EL CAMPO AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-4511
Country	:	US
Telephone Number	:	817-755-5565
Fax Number	:	817-668-0264

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

Provider Enumeration Date	:	12/13/2021
Last Update Date	:	01/20/2023

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