Healthcare Provider Details

I. General information

NPI: 1083571384
Provider Name (Legal Business Name): CHRYSOULA TAMPASIS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3954 AIRPORT BLVD
MOBILE AL
36608-2224
US

IV. Provider business mailing address

3954 AIRPORT BLVD
MOBILE AL
36608-2224
US

V. Phone/Fax

Practice location:
  • Phone: 251-343-4700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberR-366-TA-D75
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: