Basic Information
| Provider Information | |||||||||
| NPI: | 1225370224 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHMIDT | ||||||||
| FirstName: | KHYLA | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | P.A.-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HUMBLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773384513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815487334 | ||||||||
| FaxNumber: | 2815487363 | ||||||||
| Practice Location | |||||||||
| Address1: | 104 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HUMBLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773384513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815487334 | ||||||||
| FaxNumber: | 2815487363 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2013 | ||||||||
| LastUpdateDate: | 03/18/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA06126 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.