MEDICARE: DR. DAVID SCHOONOVER CFT

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	101Y00000X	Counselor	210760	TX
2	101YP2500X	Professional Counselor	210760	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	210760	OTHER	TX	NATIONAL INSTITUTE OF HEALTH

General Provider Information

NPI Number	:	1770290454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID SCHOONOVER CFT

Provider Business Mailing Address
First Line	:	8056 KINGS GUARD ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6326
Country	:	US
Telephone Number	:	903-316-3142
Fax Number	:

Provider Business Practice Location Address
First Line	:	8056 KINGS GUARD ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6326
Country	:	US
Telephone Number	:	903-316-3142
Fax Number	:

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

Provider Enumeration Date	:	11/01/2022
Last Update Date	:	11/01/2022

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