Provider Demographics
NPI:1275644528
Name:KAY, TERRY ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ALAN
Last Name:KAY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 SOUTH WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-3435
Mailing Address - Country:US
Mailing Address - Phone:972-932-6220
Mailing Address - Fax:972-932-6905
Practice Address - Street 1:1915 SOUTH WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-3435
Practice Address - Country:US
Practice Address - Phone:972-932-6220
Practice Address - Fax:972-932-6905
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2718T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10710OtherSPECTERA
TX920897Medicaid
TX920897Medicaid