Basic Information
| Provider Information | |||||||||
| NPI: | 1376736561 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TROYER | ||||||||
| FirstName: | NEAL | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11148 S LONE ELM RD | ||||||||
| Address2: | |||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660619434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133906700 | ||||||||
| FaxNumber: | 9133906705 | ||||||||
| Practice Location | |||||||||
| Address1: | 11148 S LONE ELM RD | ||||||||
| Address2: | |||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660619434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133906700 | ||||||||
| FaxNumber: | 9133906705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2007 | ||||||||
| LastUpdateDate: | 01/30/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1792 | KS | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 651185 | 01 | KS | BCBS KS | OTHER |