Provider Demographics
NPI:1629197520
Name:FAMILY OPTOMETRIC ASSOCIATES P.C.
Entity Type:Organization
Organization Name:FAMILY OPTOMETRIC ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHADO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:240-656-8181
Mailing Address - Street 1:8210 SKIPWITH DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-9499
Mailing Address - Country:US
Mailing Address - Phone:240-656-8181
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5186
Practice Address - Country:US
Practice Address - Phone:240-396-6794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001006152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD521RMedicare PIN
DCG02754Medicare PIN
VAC10197Medicare PIN