Provider Demographics
NPI:1548319635
Name:SCHNEIDER, JOHN G (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:587 E INTERSTATE 30
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-5408
Mailing Address - Country:US
Mailing Address - Phone:972-771-1818
Mailing Address - Fax:972-771-5565
Practice Address - Street 1:587 E INTERSTATE 30
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-5408
Practice Address - Country:US
Practice Address - Phone:972-771-1818
Practice Address - Fax:972-771-5565
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2882-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist