Provider Demographics
NPI:1134501075
Name:TO, TERESA (OD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:
Last Name:TO
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 1:5936 HIGHWAY 6 STE B
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4162
Mailing Address - Country:US
Mailing Address - Phone:346-395-5588
Mailing Address - Fax:
Practice Address - Street 1:5936 HIGHWAY 6 STE B
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4162
Practice Address - Country:US
Practice Address - Phone:346-395-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-28
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8702152W00000X
TX8702T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist