MEDICARE: DR. TARA ANN GEIMAN 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
1	152W00000X	Optometrist	1640DT	KY
2	152W00000X	Optometrist	OPT002524	GA
3	152W00000X	Optometrist	8183T	TX

General Provider Information

NPI Number	:	1518977354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARA ANN GEIMAN O.D.

Provider Business Mailing Address
First Line	:	2791 N NEW BRAUNFELS AVE
Second Line	:
City	:	JBSA FT SAM HOUSTON
State	:	TX
Zip	:	78234-2664
Country	:	US
Telephone Number	:	812-327-8854
Fax Number	:

Provider Business Practice Location Address
First Line	:	2791 N NEW BRAUNFELS AVE
Second Line	:
City	:	JBSA FT SAM HOUSTON
State	:	TX
Zip	:	78234-2664
Country	:	US
Telephone Number	:	812-327-8854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	02/07/2023

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