MEDICARE: DR. BURTON W SCHWARTZ MD

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	208000000X	Pediatrics Physician	E1410	TX

General Provider Information

NPI Number	:	1780800664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BURTON W SCHWARTZ MD

Provider Business Mailing Address
First Line	:	TCU PO BOX 297400
Second Line	:	BROWN LUPTON STUDENT HEALTH CENTER
City	:	FORTWORTH
State	:	TX
Zip	:	76129
Country	:	US
Telephone Number	:	817-257-7940
Fax Number	:	817-257-7279

Provider Business Practice Location Address
First Line	:	2825 STADIUM DRIVE
Second Line	:	BROWN LUPTON HEALTH CENTER TCU
City	:	FT WORTH
State	:	TX
Zip	:	76109
Country	:	US
Telephone Number	:	817-257-7940
Fax Number	:	817-257-7279

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	07/08/2007

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