Provider Demographics
NPI:1053400101
Name:SCHROTH, PAUL D (FNP)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:D
Last Name:SCHROTH
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3601 CEDAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-5286
Mailing Address - Country:US
Mailing Address - Phone:325-654-3238
Mailing Address - Fax:325-654-3283
Practice Address - Street 1:271 FORT RICHARDSON AVE
Practice Address - Street 2:GOODFELLOW AFB CLINIC
Practice Address - City:GOODFELLOW AIR FORCE BASE
Practice Address - State:TX
Practice Address - Zip Code:76908
Practice Address - Country:US
Practice Address - Phone:325-654-3238
Practice Address - Fax:325-654-3083
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX719126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily