Provider Demographics
NPI:1629521570
Name:SCHWALB, LAUREN (OD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SCHWALB
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 1:1000 DES PERES RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2062
Mailing Address - Country:US
Mailing Address - Phone:314-628-9100
Mailing Address - Fax:844-235-0998
Practice Address - Street 1:1000 DES PERES RD STE 105
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2062
Practice Address - Country:US
Practice Address - Phone:314-628-9100
Practice Address - Fax:844-235-0998
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1952152W00000X
CA34557152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1952OtherSTATE LICENSE