Physician Compare National (NPI:1417042276)

HEALTHCARE PROVIDER: MARIA LYN-SHOOP GARCIA O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1417042276
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4082755665
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100104000699
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHOOP DAVENPORT
	Individual professional last name
Provider First Name	MARIA
	Individual professional first name
Provider Middle Name	LYN
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	FERRIS STATE COLLEGE - COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	124 E PRAIRIE ST
	Group Practice or individual's line 1 address
City	VICKSBURG
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	490971257
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y