Provider Demographics
NPI:1023746005
Name:SCHNAUTZ, KIMBERLY CAROLE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CAROLE
Last Name:SCHNAUTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BEACH AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-7166
Mailing Address - Country:US
Mailing Address - Phone:936-709-1800
Mailing Address - Fax:
Practice Address - Street 1:800 BEACH AIRPORT RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-7166
Practice Address - Country:US
Practice Address - Phone:936-709-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15926235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist