Provider Demographics
NPI:1700099058
Name:SCHMITT, JASON K (OD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:K
Last Name:SCHMITT
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 1:9717 BURNEY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2306
Mailing Address - Country:US
Mailing Address - Phone:316-648-2303
Mailing Address - Fax:
Practice Address - Street 1:10210 N CENTRAL EXPY
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3425
Practice Address - Country:US
Practice Address - Phone:316-648-2303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1664152W00000X
TX7384T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist