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General NPI Number Information
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NPI Number | 1861959967
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Entity Type | Individual
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Provider Name | MONICA ALICE TADROS OD
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Gender | Female
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 11745 W INTERSTATE 10
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City | SAN ANTONIO
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State | TX
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Zip | 78230-1048
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Country | US
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Telephone | 830-357-0736
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Fax |
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Provider Business Mailing Address
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Address Line | 24918 ESTANCIA CIR
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City | SAN ANTONIO
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State | TX
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Zip | 78260-4345
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Country | US
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Telephone | 954-224-8811
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPC5623
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 10444
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License Number State | TX
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