Provider Demographics
NPI:1730482340
Name:SCHOLL, MICHAEL
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SCHOLL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 MONTECILLO BLVD
Mailing Address - Street 2:APT 1003
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4917
Mailing Address - Country:US
Mailing Address - Phone:575-496-2721
Mailing Address - Fax:
Practice Address - Street 1:130 MONTECILLO BLVD
Practice Address - Street 2:APT 1003
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4917
Practice Address - Country:US
Practice Address - Phone:575-496-2721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-21
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX677399367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered