Organization
TRACY L SCHILLERSTROM M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY LYNN SCHILLERSTROM M.D. (OWNER)
(210) 680-5543
Entity
Organization
Contact information
Practice address
9150 HUEBNER RD STE 255, SAN ANTONIO, TX 78240-1545
(210) 641-1800
(210) 641-1816
Mailing address
7222 TIMBERLEAF ST, SAN ANTONIO, TX 78238-1350
(210) 680-5543
(210) 641-1816
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
M3083
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M3083
TX MEDICAL LICENSE #
TX
Enumeration date
10/18/2006
Last updated
08/14/2007
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