Basic Information
| Provider Information | |||||||||
| NPI: | 1568407252 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHIESS | ||||||||
| FirstName: | MYA | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6410 FANNIN ST STE 1010 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770305301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323257080 | ||||||||
| FaxNumber: | 8323257263 | ||||||||
| Practice Location | |||||||||
| Address1: | 6410 FANNIN ST STE 1010 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770305301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323257080 | ||||||||
| FaxNumber: | 8323257263 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2006 | ||||||||
| LastUpdateDate: | 10/06/2017 | ||||||||
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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 | 2084N0400X | G7427 | TX | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 8I29120 | 01 | TX | MEDICARE | OTHER | 130022625 | 01 | TX | RAILROAD MEDICARE | OTHER | 187563504 | 01 | TX | CSHCN | OTHER | 84232K | 01 | TX | BCBS | OTHER | 124360206 | 05 | TX | MEDICAID |