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Organization

TRI CITY OPTOMETRIC, P.A.

Active
Other names
Tri City Optometric
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TROY N TEVIS O.D., PHD (OWNER DOCTOR)
(828) 288-8662
Entity
Organization

Contact information

Practice address
337 N MAIN ST, RUTHERFORDTON, NC 28139-2505
(828) 288-8662
(828) 288-4882
Mailing address
337 N MAIN ST, RUTHERFORDTON, NC 28139-2505
(828) 288-8662
(828) 288-4882

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1807
NC
152WC0802X
Corneal and Contact Management Optometrist
1807
NC
152WP0200X
Pediatric Optometrist
1807
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
012F0
BCBS GROUP
NC
01
0313616
CIGNA HEALTHCARE
NC
01
24491
OPTICARE
NC
01
71877
MEDCOST
NC
05
89012F0
NC
05
89016R5
NC
Enumeration date
01/12/2007
Last updated
07/15/2010
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