MEDICARE: MONICA ALICE TADROS OD

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	10444	TX
2	152W00000X	Optometrist	OPC5623	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861959967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA ALICE TADROS OD

Provider Business Mailing Address
First Line	:	11745 W IH 10
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-1048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11745 W INTERSTATE 10
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-1048
Country	:	US
Telephone Number	:	830-357-0736
Fax Number	:

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

Provider Enumeration Date	:	02/25/2019
Last Update Date	:	04/27/2026

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