Provider Demographics
NPI:1275783185
Name:CAMERO, CHARLINE L (OD)
Entity Type:Individual
Prefix:DR
First Name:CHARLINE
Middle Name:L
Last Name:CAMERO
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 1:5050 TROUP HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75707-1916
Mailing Address - Country:US
Mailing Address - Phone:903-534-0755
Mailing Address - Fax:
Practice Address - Street 1:5050 TROUP HWY
Practice Address - Street 2:SUITE A
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75707-1916
Practice Address - Country:US
Practice Address - Phone:903-534-0755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-27
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12605T152W00000X
TX7687 T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist