Provider Demographics
NPI:1285739391
Name:SCHAEFER, STEPHEN D (OD, PA)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:D
Last Name:SCHAEFER
Suffix:
Gender:M
Credentials:OD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 WILLIAMS DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-4115
Mailing Address - Country:US
Mailing Address - Phone:512-863-2078
Mailing Address - Fax:512-869-2077
Practice Address - Street 1:1401 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-4115
Practice Address - Country:US
Practice Address - Phone:512-863-2078
Practice Address - Fax:512-869-2077
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1966T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0283750001Medicare NSC
TXP00174676Medicare PIN
TX8C9085Medicare PIN
TXT15749Medicare UPIN