Provider Demographics
NPI:1376629188
Name:TEUNIS, ROBERT H JR (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:TEUNIS
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16819 CRABBS BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2215
Mailing Address - Country:US
Mailing Address - Phone:301-948-9171
Mailing Address - Fax:301-926-1432
Practice Address - Street 1:16819 CRABBS BRANCH WAY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20855-2215
Practice Address - Country:US
Practice Address - Phone:301-948-9171
Practice Address - Fax:301-926-1432
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA975152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01055OtherMEDICARE GROUP PIN
MDG01055OtherMEDICARE GROUP PIN
MDU69932Medicare UPIN