Tracy L Schillerstrom M.D., P.a.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

M3083 Issued in TX

Legal business name

TRACY L SCHILLERSTROM M.D., P.A.

Practice address

9150 Huebner Rd Ste 255
San Antonio, TX 78240-1545

Phone

(210) 641-1800

Fax

(210) 641-1816

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Tracy Lynn Schillerstrom, M.D.

Title

Owner

Phone

(210) 680-5543

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1962583930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7222 TIMBERLEAF ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381350",
            "telephone_number": "210-680-5543",
            "fax_number": "210-641-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9150 HUEBNER RD STE 255",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401545",
            "telephone_number": "210-641-1800",
            "fax_number": "210-641-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY L SCHILLERSTROM M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "SCHILLERSTROM",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-680-5543",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "M3083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICAL LICENSE #",
            "identifier": "M3083",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.