Provider Demographics
NPI:1346793411
Name:TROUT, ASHLEY LYNN (OD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:TROUT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:LYNN
Other - Last Name:PYLANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:5221 S COULTER ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6676
Mailing Address - Country:US
Mailing Address - Phone:806-358-3594
Mailing Address - Fax:806-457-1660
Practice Address - Street 1:5221 S COULTER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6676
Practice Address - Country:US
Practice Address - Phone:806-358-3594
Practice Address - Fax:806-457-1660
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2905152W00000X
TX9070TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist