Provider Demographics
NPI:1295722262
Name:SCHROEDER, THOMAS CHRISTOPHER (OD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CHRISTOPHER
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4375 BELVEDERE RD
Mailing Address - Street 2:SCHROEDER EYE CARE, LLC
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-1545
Mailing Address - Country:US
Mailing Address - Phone:561-242-5115
Mailing Address - Fax:561-242-5285
Practice Address - Street 1:4375 BELVEDERE RD
Practice Address - Street 2:SCHROEDER EYE CARE, LLC
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-1545
Practice Address - Country:US
Practice Address - Phone:561-242-5115
Practice Address - Fax:561-242-5285
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC003742152W00000X
MO2002016075152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100734OtherNVA
FL6212298Medicaid
FLBCBS20048OtherBCBS
FL24912OtherSPECTERA
FL6599539OtherGHI
FL63212OtherSAFEGUARD
FL44644OtherDAVIS VISION
FL44644OtherDAVIS VISION
FLPTAN U0052YMedicare ID - Type UnspecifiedT CHRIS SCHROEDER, OD
FLPTAN AC379Medicare ID - Type UnspecifiedSCHROEDER EYE CARE