Provider Demographics
NPI:1871154245
Name:SCHUWERK, MARY E (PA-C)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:E
Last Name:SCHUWERK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10597
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78766-1597
Mailing Address - Country:US
Mailing Address - Phone:512-485-5889
Mailing Address - Fax:512-420-0397
Practice Address - Street 1:1180 SETON PKWY STE 410
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6184
Practice Address - Country:US
Practice Address - Phone:512-504-0057
Practice Address - Fax:512-744-0413
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13183363A00000X
TXPA13181363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX407310801Medicaid