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NPI Code Detail

MEDICARE: DR. VANESSA TILLEY-CHRISTOPHERSON O.D.

MEDICARE: DR. VANESSA TILLEY-CHRISTOPHERSON O.D.
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
1152W00000XOptometristMD.1131-225TLA
2152W00000XOptometrist6883TGTX

Other Identifiers

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

General Provider Information

NPI Number : 1336171784
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VANESSA TILLEY-CHRISTOPHERSON O.D.
Provider Business Mailing Address
First Line : 6419 SKILLMAN ST
Second Line :
City : DALLAS
State : TX
Zip : 75231-7109
Country : US
Telephone Number : 214-503-0997
Fax Number : 214-503-0657
Provider Business Practice Location Address
First Line : 6419 SKILLMAN ST
Second Line :
City : DALLAS
State : TX
Zip : 75231-7109
Country : US
Telephone Number : 214-503-0997
Fax Number : 214-503-0657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 09/17/2009

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