Provider Demographics
NPI:1225413503
Name:MENDEZ ROMERO, TAMARA (OD)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:MENDEZ ROMERO
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 1:8401 CONNECTICUT AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5820
Mailing Address - Country:US
Mailing Address - Phone:301-242-3927
Mailing Address - Fax:954-262-2269
Practice Address - Street 1:8401 CONNECTICUT AVE STE 102
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5820
Practice Address - Country:US
Practice Address - Phone:301-242-3927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2476152W00000X
FLOFC72152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist