Provider Demographics
NPI:1841283181
Name:SCHROEPPEL, CHARLES CONRAD (OD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:CONRAD
Last Name:SCHROEPPEL
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:505 UNIVERSITY DR E
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-5901
Mailing Address - Country:US
Mailing Address - Phone:979-846-0377
Mailing Address - Fax:979-846-4829
Practice Address - Street 1:505 UNIVERSITY DR E
Practice Address - Street 2:SUITE 101
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-5901
Practice Address - Country:US
Practice Address - Phone:979-846-0377
Practice Address - Fax:979-846-4829
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX2425T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU14048Medicare UPIN