National Provider Identifier

Charles Frederick Tiexeira, LDO

Charles Frederick Tiexeira, LDO is listed in the NPPES registry with a primary specialty of Optician in Kenmore, NY and a listed phone number of (716) 874-4119.

NPI 1366614133Kenmore, NYOptician

Profile Overview

NPI
1366614133
Provider Type
Individual
Primary Specialty
Optician
Enumeration Date
April 01, 2008
Last Updated
April 01, 2008

Practice Location

  • 2864 Delaware Ave
  • Kenmore, NY 14217-2731

Phone: (716) 874-4119

Specialties

  • Optician (156FX1800X)
Full Record
NPI
1366614133
Entity Type
Individual
Last Name
Tiexeira
First Name
Charles
Middle Name
Frederick
Credential
LDO
Mailing Street Address
2864 Delaware Ave
Mailing City
Kenmore
Mailing State
NY
Mailing ZIP Code
14217-2731
Mailing Country
US
Mailing Phone
(716) 874-4119
Practice Street Address
2864 Delaware Ave
Practice City
Kenmore
Practice State
NY
Practice ZIP Code
14217-2731
Practice Country
US
Practice Phone
(716) 874-4119
Enumeration Date
April 01, 2008
Last Updated
April 01, 2008
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Optician (156FX1800X)