Provider Demographics
NPI:1306973417
Name:SCHROEDER SWARTZ, TRACY LYNN (OD, MS)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:LYNN
Last Name:SCHROEDER SWARTZ
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:LYNN
Other - Last Name:SCHROEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:100A PROVIDENCE MAIN ST NW STE 1E
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-4825
Mailing Address - Country:US
Mailing Address - Phone:256-382-2700
Mailing Address - Fax:256-382-2705
Practice Address - Street 1:100A PROVIDENCE MAIN ST NW STE 1E
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4825
Practice Address - Country:US
Practice Address - Phone:256-382-2700
Practice Address - Fax:256-382-2705
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN2229152WC0802X
ALR-176-TA-786152W00000X
ALR176TA786152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU56451Medicare UPIN