Basic Information
| Provider Information | |||||||||
| NPI: | 1487665097 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHROTH | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6550 FANNIN ST | ||||||||
| Address2: | SUITE 1901 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134411100 | ||||||||
| FaxNumber: | 7137902643 | ||||||||
| Practice Location | |||||||||
| Address1: | 6550 FANNIN ST | ||||||||
| Address2: | SUITE 1901 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134411100 | ||||||||
| FaxNumber: | 7137902643 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2006 | ||||||||
| LastUpdateDate: | 10/19/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | F3604 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207RC0000X | F3604 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | P01309351 | 01 | TX | RR MEDICARE | OTHER | 136126312 | 05 | TX | MEDICAID | 1487665097 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | 136126311 | 05 | TX | MEDICAID | 136126309 | 05 | TX | MEDICAID | 136126316 | 05 | TX | MEDICAID | P01037133 | 01 | TX | RR MEDICARE | OTHER | 136126310 | 05 | TX | MEDICAID | 136126313 | 05 | TX | MEDICAID | 136126315 | 05 | TX | MEDICAID | 1822591 | 05 | LA | MEDICAID | P00849862 | 01 | TX | MEDICARE RAILROAD | OTHER | 8CB396 | 01 | TX | BCBS | OTHER |