Provider Demographics
NPI:1053974717
Name:SCHURTZ, ALLYSON MARIE (LAC)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:MARIE
Last Name:SCHURTZ
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 DOUBLE CREEK DR STE 304
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-3831
Mailing Address - Country:US
Mailing Address - Phone:512-246-0220
Mailing Address - Fax:
Practice Address - Street 1:2251 DOUBLE CREEK DR STE 304
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3831
Practice Address - Country:US
Practice Address - Phone:336-408-8929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02718171100000X
TXACU01856171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist