Provider Demographics
NPI:1205851300
Name:SCHAMERLOH, RYAN C (OD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:C
Last Name:SCHAMERLOH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2959 S BUCKNER BLVD
Mailing Address - Street 2:STE. 700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-6945
Mailing Address - Country:US
Mailing Address - Phone:214-239-2176
Mailing Address - Fax:214-239-2177
Practice Address - Street 1:2959 S BUCKNER BLVD STE 700
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-6950
Practice Address - Country:US
Practice Address - Phone:214-239-2176
Practice Address - Fax:214-239-2177
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6956TG152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181434501Medicaid
TX301821005Medicaid
TX181434503Medicaid
TX6956TGOtherTEXAS OPTOMETRY BOARD
TX301821003Medicaid
TX181434505Medicaid