Provider Demographics
NPI:1225370224
Name:SCHMIDT, KHYLA ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:KHYLA
Middle Name:ANNE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4513
Mailing Address - Country:US
Mailing Address - Phone:281-548-7334
Mailing Address - Fax:281-548-7363
Practice Address - Street 1:104 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4513
Practice Address - Country:US
Practice Address - Phone:281-548-7334
Practice Address - Fax:281-548-7363
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06126363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical