Provider Demographics
NPI:1508488123
Name:TAMARA MENDEZ OD LLC
Entity Type:Organization
Organization Name:TAMARA MENDEZ OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:240-626-3461
Mailing Address - Street 1:12400 PARK POTOMAC AVE APT 404
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-6987
Mailing Address - Country:US
Mailing Address - Phone:240-626-3461
Mailing Address - Fax:
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:240-626-3461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty