Basic Information
| Provider Information | |||||||||
| NPI: | 1477005890 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SCHROEDER | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | K | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10555 CULEBRA RD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782513666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2108886042 | ||||||||
| FaxNumber: | 2108886042 | ||||||||
| Practice Location | |||||||||
| Address1: | 10555 CULEBRA RD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782513666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2108886042 | ||||||||
| FaxNumber: | 2108886042 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2016 | ||||||||
| LastUpdateDate: | 11/02/2016 | ||||||||
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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 | 225100000X | 1280186 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.