MEDICARE: CAM TIEU NGO OD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	152W00000X	Optometrist	2764	NC

General Provider Information

NPI Number	:	1679261499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAM TIEU NGO OD

Provider Business Mailing Address
First Line	:	PO BOX 207261
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-7261
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007 SKYWAY DR STE A
Second Line	:
City	:	MONROE
State	:	NC
Zip	:	28110-3051
Country	:	US
Telephone Number	:	704-289-1547
Fax Number	:

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

Provider Enumeration Date	:	04/28/2023
Last Update Date	:	09/12/2023

Similar Medicare Providers

1700207511 — SITA PATEL OD
Practice Location Address:

1007 SKYWAY DR STE A
MONROE, NC
28110-3051

Practice Phone: 704-289-1547
Practice Fax: 704-291-9441

1306360870 — LAUREN SLEDGE BLACKMON SLP
Practice Location Address:

107 SUMMER LANE
WEST MONROE, LA
71291-3051

Practice Phone: 318-396-1969
Practice Fax: 318-396-1970

1952246720 — JACQUELINE GIRON-DIAZ
Practice Location Address:

3217 VAGABOND DR
MONROE, NC
28110-8547

Practice Phone: 980-331-4484
Practice Fax:

1205771946 — BELINE BILLINI
Practice Location Address:

2307 PEBBLE CLOSE CT
MONROE, NC
28110-5409

Practice Phone: 704-352-0887
Practice Fax:

1972448249 — AMBER SPARKS OTD, OTR/L
Practice Location Address:

5210 ROGERS RD
MONROE, NC
28110-7362

Practice Phone: 704-296-3035
Practice Fax:

1629511761 — DEBORAH ANN COLUMBRO LMHC
Practice Location Address:

3546 SECREST LNDG
MONROE, NC
28110-7183

Practice Phone: 631-617-2263
Practice Fax:

Directions to “ CAM TIEU NGO OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.