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General NPI Number Information
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NPI Number | 1891340253
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Entity Type | Individual
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Provider Name | SHEA SCHMIDT OD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2019
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 317 E AQUARIUM PL
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City | JENKS
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State | OK
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Zip | 74037-6811
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Country | US
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Telephone | 918-296-4733
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Fax |
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Provider Business Mailing Address
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Address Line | 317 E AQUARIUM PL
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City | JENKS
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State | OK
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Zip | 74037-6811
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Country | US
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Telephone | 918-296-4733
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3038
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License Number State | OK
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