Individual
DR. THERESA J. HAAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D
Contact information
Practice address
400 E 18TH ST, CHEYENNE, WY 82001-4616
(307) 634-4232
(307) 778-8429
Mailing address
400 E 18TH ST, CHEYENNE, WY 82001-4616
(307) 634-4232
(307) 778-8429
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
238T
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114039600
—
WY
01
—
307865
BLUE CROSS BLUE SHEILD
WY
01
—
36203
DAVIS VISION
WY
01
—
410041316
RAIL ROAD MEDICARE
WY
Enumeration date
08/31/2005
Last updated
10/13/2008
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