Individual
MS. JENNIFER LEIGH SCHUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1301 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2122
(972) 249-0200
Mailing address
6451 BRENTWOOD STAIR RD, SUITE 100, FORT WORTH, TX 76112-3200
(972) 249-0200
(972) 249-0206
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-29770
KS
207R00000X
Internal Medicine Physician
2002008094
MO
207R00000X
Internal Medicine Physician
Primary
R0950
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100426410A
—
KS
05
—
100426410B
—
KS
05
—
205815103
—
MO
01
—
31206011
BCBS
—
01
—
502470
FIRST GUARD
—
01
—
7474346
AETNA
—
Enumeration date
08/31/2005
Last updated
03/02/2017
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