MEDICARE: DR. CHARLES CONRAD SCHROEPPEL O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2425T	TX

General Provider Information

NPI Number	:	1841283181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES CONRAD SCHROEPPEL O.D.

Provider Business Mailing Address
First Line	:	505 UNIVERSITY DR E
Second Line	:	SUITE 101
City	:	COLLEGE STATION
State	:	TX
Zip	:	77840-5901
Country	:	US
Telephone Number	:	979-846-0377
Fax Number	:	979-846-4829

Provider Business Practice Location Address
First Line	:	505 UNIVERSITY DR E
Second Line	:	SUITE 101
City	:	COLLEGE STATION
State	:	TX
Zip	:	77840-5901
Country	:	US
Telephone Number	:	979-846-0377
Fax Number	:	979-846-4829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	07/09/2007

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