Provider Demographics
NPI:1710057070
Name:SCHOBELOCK, THOMAS F (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:SCHOBELOCK
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 1:2144 N BELT LINE RD STE C
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-5860
Mailing Address - Country:US
Mailing Address - Phone:972-329-1828
Mailing Address - Fax:972-329-1628
Practice Address - Street 1:2144 N BELT LINE RD STE C
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5860
Practice Address - Country:US
Practice Address - Phone:972-329-1828
Practice Address - Fax:972-329-1628
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX03845T152W00000X
TN2086538152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1272486Medicaid
TX1272486Medicaid
TXT90584Medicare UPIN