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NPI Code Detail

MEDICARE: MRS. KATHLEEN MARION SCHLEBACH RDH BS

MEDICARE: MRS. KATHLEEN MARION SCHLEBACH RDH BS
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
1124Q00000XDental Hygienist13722TX

General Provider Information

NPI Number : 1891810032
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHLEEN MARION SCHLEBACH RDH BS
Provider Business Mailing Address
First Line : 3541 W WALNUT HILL LANE
Second Line : # 2036
City : IRVING
State : TX
Zip : 75038
Country : US
Telephone Number : 214-674-8399
Fax Number : 972-618-9369
Provider Business Practice Location Address
First Line : 6841 COIT RD
Second Line :
City : PLANO
State : TX
Zip : 75024-5417
Country : US
Telephone Number : 972-618-5000
Fax Number : 972-618-9369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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