Provider Demographics
NPI:1588664189
Name:MENDE, SILVIA (OD)
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:MENDE
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 1:1798 ROANE STATE HWY
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-8305
Mailing Address - Country:US
Mailing Address - Phone:865-882-7470
Mailing Address - Fax:865-882-2738
Practice Address - Street 1:1798 ROANE STATE HWY
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-8305
Practice Address - Country:US
Practice Address - Phone:865-882-7470
Practice Address - Fax:865-882-2738
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD1349152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4037769OtherBLUECROSS
TN3942648Medicare PIN