MEDICARE: DR. TERESA TO O.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	8702	TX
2	152W00000X	Optometrist	8702T	TX

General Provider Information

NPI Number	:	1134501075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERESA TO O.D

Provider Business Mailing Address
First Line	:	5936 HIGHWAY 6 STE B
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4162
Country	:	US
Telephone Number	:	346-395-5588
Fax Number	:

Provider Business Practice Location Address
First Line	:	5936 HIGHWAY 6 STE B
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4162
Country	:	US
Telephone Number	:	346-395-5588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2015
Last Update Date	:	10/12/2023

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