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General NPI Number Information
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NPI Number | 1801122262
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Entity Type | Organization
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Legal Business Name | ROCKWALL PRECISION EYECARE PLLC
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 2931 RIDGE RD STE 109
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City | ROCKWALL
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State | TX
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Zip | 75032-6668
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Country | US
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Telephone | 972-772-2644
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Fax | 972-722-1670
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Provider Business Mailing Address
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Address Line | 2931 RIDGE RD., SUITE 109
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City | ROCKWALL
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State | TX
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Zip | 75032-6668
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Country | US
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Telephone | 972-772-2644
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Fax | 972-722-1670
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRENT D. SCHMIDLAP
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Credential | O.D.
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Telephone | 972-772-2644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5950T
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License Number State | TX
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