Provider Demographics
NPI:1235284761
Name:CHAMBERLIN, TIFFANY MATHAS (OD)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:MATHAS
Last Name:CHAMBERLIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:ANNE
Other - Last Name:MATHAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1834 KELLER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248
Mailing Address - Country:US
Mailing Address - Phone:817-431-4900
Mailing Address - Fax:817-431-4492
Practice Address - Street 1:1015 WEST VIEW PARK DRIVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15229
Practice Address - Country:US
Practice Address - Phone:412-931-8101
Practice Address - Fax:412-931-8103
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3721152W00000X
PAOET008883152W00000X, 152WC0802X
TX10138T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU93655Medicare UPIN
PAU93655Medicare UPIN