Healthcare Provider Details

I. General information

NPI: 1053084129
Provider Name (Legal Business Name): TEESHA DARLENE WEBB OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TEESHA DARLENE FREY OD

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20630 STATE HIGHWAY 46 W STE 120
SPRING BRANCH TX
78070-6855
US

IV. Provider business mailing address

20630 STATE HIGHWAY 46 W STE 120
SPRING BRANCH TX
78070-6855
US

V. Phone/Fax

Practice location:
  • Phone: 830-980-3306
  • Fax: 830-438-3306
Mailing address:
  • Phone: 563-379-5914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number10347TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: