Provider Demographics
NPI:1548850308
Name:SCHRODER CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SCHRODER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:HAGEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRODER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:737-222-6014
Mailing Address - Street 1:1221 W BEN WHITE BLVD STE 110A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6888
Mailing Address - Country:US
Mailing Address - Phone:737-222-6014
Mailing Address - Fax:737-222-5986
Practice Address - Street 1:1221 W BEN WHITE BLVD STE 110A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6888
Practice Address - Country:US
Practice Address - Phone:737-222-6014
Practice Address - Fax:737-222-5986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX552311ZX6WMedicaid