Provider Demographics
NPI:1497870349
Name:SCHPOK, RODNEY BRUCE (OD)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:BRUCE
Last Name:SCHPOK
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 1:5622 E MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-5346
Mailing Address - Country:US
Mailing Address - Phone:214-369-3937
Mailing Address - Fax:214-887-8097
Practice Address - Street 1:5622 E MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-5346
Practice Address - Country:US
Practice Address - Phone:214-369-3937
Practice Address - Fax:214-887-8097
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2937152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist