Individual
JACK LESTER SCHWADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7777 FOREST LN, SUITE C339, DALLAS, TX 75230-2571
(972) 566-8855
(972) 566-7509
Mailing address
7777 FOREST LN, SUITE C339, DALLAS, TX 75230-2571
(972) 566-8855
(972) 566-7509
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D3394
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099892401
—
TX
05
—
099892404
—
TX
05
—
099892405
—
TX
Enumeration date
11/01/2006
Last updated
02/01/2022
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