Provider Demographics
NPI:1649541053
Name:SCHUTTE, MEGHAN ANNE (OD)
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:ANNE
Last Name:SCHUTTE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 RESEARCH BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5814
Mailing Address - Country:US
Mailing Address - Phone:512-694-7158
Mailing Address - Fax:512-345-1046
Practice Address - Street 1:10000 RESEARCH BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5854
Practice Address - Country:US
Practice Address - Phone:512-694-7158
Practice Address - Fax:512-345-1046
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7958TG152W00000X
PAOEG002564152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1907DTOtherKY MEDICAL LICENSE
KY1907DTOtherKY MEDICAL LICENSE