Healthcare Provider Details

I. General information

NPI: 1649174467
Provider Name (Legal Business Name): LYSSA SCHABEL OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6708 RAYTOWN RD
RAYTOWN MO
64133-5272
US

IV. Provider business mailing address

5135 MERRIAM DR
SHAWNEE KS
66203-2167
US

V. Phone/Fax

Practice location:
  • Phone: 816-353-1872
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2026048372
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: