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General NPI Number Information
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NPI Number | 1336300730
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Entity Type | Organization
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Legal Business Name | SCHROEDER OPTICAL
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 9600 LILE DR STE 260
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6373
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Country | US
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Telephone | 501-224-4484
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Fax | 501-221-3031
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Provider Business Mailing Address
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Address Line | 9600 LILE DR STE 260
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6373
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Country | US
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Telephone | 501-224-4484
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Fax | 501-221-3031
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE SCHROEDER
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Credential | M.D.
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Telephone | 501-224-4484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | R1935
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License Number State | AR
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