Provider Demographics
NPI:1316947823
Name:SCHNEIDER, RUTH ANN (NP)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:ANN
Other - Last Name:SCHNEIDER-JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-5505
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7201
Practice Address - Country:US
Practice Address - Phone:214-645-5505
Practice Address - Fax:214-645-0078
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP108107363L00000X
TX511706363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87N336Medicare ID - Type Unspecified00968R
TX87N336Medicare ID - Type Unspecified00968R
TX138904115Medicaid
TXS83341Medicare UPIN