Individual provider Active NPI

Alvin Lee Schlichtemeier, M.D.

  • Radiation Oncology Physician
  • Bryan, TX
National Provider Identifier
1366415416
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
F6107 Issued in TX
Practice address
2215 E Villa Maria Rd
Suite 130
Bryan, TX 77802-2548
Phone
(979) 774-0808
Fax
(979) 776-3028
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X F6107 TX Primary

Addresses

Primary practice location

2215 E Villa Maria Rd
Suite 130
Bryan, TX 77802-2548

Mailing address

P.O. Box 2289
Coppell, TX 75019-2289
Phone (972) 867-6916

Other identifiers 1

IdentifierTypeStateIssuer
135743601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
F6107TXMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Physician Associates PastSince May 1, 2007 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1366415416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2289",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192289",
            "telephone_number": "972-867-6916",
            "fax_number": "972-867-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 E VILLA MARIA RD",
            "address_2": "SUITE 130",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022548",
            "telephone_number": "979-774-0808",
            "fax_number": "979-776-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLICHTEMEIER",
        "first_name": "ALVIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "F6107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135743601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.