Provider Demographics
NPI:1437331923
Name:VOYLES, THERESA PALMA (OD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:PALMA
Last Name:VOYLES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:THERESA
Other - Middle Name:PALMA
Other - Last Name:VOYLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:18900 MICHIGAN AVE
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3929
Mailing Address - Country:US
Mailing Address - Phone:313-271-0383
Mailing Address - Fax:
Practice Address - Street 1:18900 MICHIGAN AVE
Practice Address - Street 2:SUITE 1001
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3929
Practice Address - Country:US
Practice Address - Phone:313-271-0383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003309152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist