Active NPI
Mark Lee Schanbaum, ABOC
- Optician
- Lewisville, TX
National Provider Identifier
1730488156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 10503
- Practice address
- 2540 King Arthur Blvd
Suite 103
Lewisville, TX 75056-5512 - Phone
- (972) 899-1222
- Fax
- (972) 899-1222
- NPI assigned
- Mar 24, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 10503 | TX | Primary |
Addresses
Primary practice location
2540 King Arthur Blvd
Suite 103
Lewisville, TX 75056-5512
Mailing address
2540 King Arthur Blvd
Suite 103
Lewisville, TX 75056-5512
Phone (972) 899-1222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10503 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300924800000",
"number": "1730488156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2540 KING ARTHUR BLVD",
"address_2": "SUITE 103",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750565512",
"telephone_number": "972-899-1222",
"fax_number": "972-899-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2540 KING ARTHUR BLVD",
"address_2": "SUITE 103",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750565512",
"telephone_number": "972-899-1222",
"fax_number": "972-899-1222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHANBAUM",
"first_name": "MARK",
"middle_name": "LEE",
"credential": "ABOC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-24",
"last_updated": "2011-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "TX",
"license": "10503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.