Provider Demographics
NPI:1285662031
Name:THOMAS H MURPHY O D INC
Entity Type:Organization
Organization Name:THOMAS H MURPHY O D INC
Other - Org Name:EYE DESIGNS OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:QT
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-929-5909
Mailing Address - Street 1:1689 ARDEN WAY, SUITE 1091
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4096
Mailing Address - Country:US
Mailing Address - Phone:916-929-5909
Mailing Address - Fax:919-929-4189
Practice Address - Street 1:1689 ARDEN WAY, SUITE 1091
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4096
Practice Address - Country:US
Practice Address - Phone:916-929-5909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGDS004820Medicaid
CAZZZ64886ZOtherBLUE SHIELDS
CA314522230OtherVSP, SUPERIOR
CA314522230OtherVSP, SUPERIOR
CAP00233641Medicare ID - Type UnspecifiedRAILROAD MEDICARE
CAGDS004820Medicaid