Provider Demographics
NPI:1568958957
Name:SCHWAB, ALEXANDRA E (OD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:E
Last Name:SCHWAB
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 1:530 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-1188
Mailing Address - Country:US
Mailing Address - Phone:276-223-0033
Mailing Address - Fax:276-223-0327
Practice Address - Street 1:530 W RIDGE RD
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-1188
Practice Address - Country:US
Practice Address - Phone:276-223-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002669152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist