Individual
JOHANNA B SCHORCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
102 E YOUNG ST, LLANO, TX 78643-1349
(325) 247-4131
(325) 248-2099
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00215
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10013424
AMERIGROUP
TX
Enumeration date
11/18/2005
Last updated
10/14/2020
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