Basic Information
| Provider Information | |||||||||
| NPI: | 1720161284 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHNEIDER-DONLEY | ||||||||
| FirstName: | CAROLYN | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11103 WEST AVENUE | ||||||||
| Address2: | SUITE 6 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105246803 | ||||||||
| FaxNumber: | 2105246587 | ||||||||
| Practice Location | |||||||||
| Address1: | 622 N. CHURCH STREET | ||||||||
| Address2: | |||||||||
| City: | WATERTOWN | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9202629200 | ||||||||
| FaxNumber: | 9202628915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2519-035 | WI | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.