Provider Demographics
NPI:1245383843
Name:ANDO, MAY TYAN (OD)
Entity Type:Individual
Prefix:DR
First Name:MAY
Middle Name:TYAN
Last Name:ANDO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MAY
Other - Middle Name:TYAN
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 160308
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78280-2508
Mailing Address - Country:US
Mailing Address - Phone:210-366-1199
Mailing Address - Fax:210-349-7111
Practice Address - Street 1:15677B SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3732
Practice Address - Country:US
Practice Address - Phone:210-490-9205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11240T152W00000X
TX8721T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist