Provider Demographics
NPI:1790944411
Name:SAMUEL H. SCHMID O.D.
Entity Type:Organization
Organization Name:SAMUEL H. SCHMID O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHMID
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-848-3619
Mailing Address - Street 1:1408 W BRITTON RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-1316
Mailing Address - Country:US
Mailing Address - Phone:405-848-3619
Mailing Address - Fax:405-848-3646
Practice Address - Street 1:1408 W BRITTON RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-1316
Practice Address - Country:US
Practice Address - Phone:405-848-3619
Practice Address - Fax:405-848-3646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1115152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1548200108OtherBLUE CROSS BLUE SHIELD
OK100765000AMedicaid
OK1548200108Medicare PIN
OK0705410001Medicare NSC
OKT40638Medicare UPIN
OK1790944411Medicare PIN