Provider Demographics
NPI:1548824345
Name:SCHOONOVER, JOHN BRADLEY JR (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:BRADLEY
Last Name:SCHOONOVER
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1441 S MIDLOTHIAN PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-5592
Mailing Address - Country:US
Mailing Address - Phone:469-800-9600
Mailing Address - Fax:469-800-9630
Practice Address - Street 1:1441 S MIDLOTHIAN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-5592
Practice Address - Country:US
Practice Address - Phone:469-800-9600
Practice Address - Fax:469-800-9630
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7082207Q00000X
TXT8646207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine