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General NPI Number Information
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NPI Number | 1811079627
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Entity Type | Organization
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Legal Business Name | THEODORE R. SAMES, JR., O.D.
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 4706 LIBRARY RD
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City | BETHEL PARK
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State | PA
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Zip | 15102-2873
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Country | US
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Telephone | 412-831-7757
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Fax | 412-854-3252
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Provider Business Mailing Address
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Address Line | 4706 LIBRARY RD
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City | BETHEL PARK
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State | PA
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Zip | 15102-2873
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Country | US
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Telephone | 412-831-7757
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Fax | 412-854-3252
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Authorized Official
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Title or Position | OWNER OPTOMETRIST
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Name | DR. THEODORE R SAMES JR.
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Credential | O.D.
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Telephone | 412-831-7757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG000971
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License Number State | PA
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