Provider Demographics
NPI:1669584272
Name:TAMMI LYN SCHLICHTEMEIER P.A.
Entity type:Organization
Organization Name:TAMMI LYN SCHLICHTEMEIER P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMI
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:SCHLICHTEMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-393-8687
Mailing Address - Street 1:1705 E BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-9606
Mailing Address - Country:US
Mailing Address - Phone:972-393-8687
Mailing Address - Fax:972-393-4975
Practice Address - Street 1:1705 E BELT LINE RD
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-9606
Practice Address - Country:US
Practice Address - Phone:972-393-8687
Practice Address - Fax:972-393-4975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJO246208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083603301Medicaid
TX083603301Medicaid
TXK97JMedicare ID - Type UnspecifiedGROUP NUMBER