Provider Demographics
NPI:1073562153
Name:CONATSER, TAMARA M (OD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:M
Last Name:CONATSER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 GRAMERCY ST STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1756
Mailing Address - Country:US
Mailing Address - Phone:713-668-6828
Mailing Address - Fax:
Practice Address - Street 1:1699 RESEARCH FOREST DR STE 150
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3685
Practice Address - Country:US
Practice Address - Phone:281-363-2071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5110TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102770803Medicaid
8257059OtherBCBS LINK
TX102770801Medicaid
83932JOtherBLUE CROSS
83932JMedicare ID - Type Unspecified
410043634OtherRAILROAD MEDICARE