Provider Demographics
NPI:1902082316
Name:FAYE N. TUPA, O.D., P.C.
Entity Type:Organization
Organization Name:FAYE N. TUPA, O.D., P.C.
Other - Org Name:FAYE N. TUPA, O.D.,P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:TUPA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:361-771-3202
Mailing Address - Street 1:1308 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5911
Mailing Address - Country:US
Mailing Address - Phone:361-573-2021
Mailing Address - Fax:361-573-4047
Practice Address - Street 1:1308 N MAIN ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5911
Practice Address - Country:US
Practice Address - Phone:361-573-2021
Practice Address - Fax:361-573-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6286TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty