Provider Demographics
NPI:1891853297
Name:CAMP, TERESA (OD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:
Last Name:CAMP
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 1:808 CLAY LOOP
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-4926
Mailing Address - Country:US
Mailing Address - Phone:210-324-7580
Mailing Address - Fax:
Practice Address - Street 1:4400 FREDERICKSBURG RD STE 107
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-1969
Practice Address - Country:US
Practice Address - Phone:210-737-1926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6986T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist