Provider Demographics
NPI:1629840319
Name:TROY HUMPHREYS, OD
Entity Type:Organization
Organization Name:TROY HUMPHREYS, OD
Other - Org Name:PREFERRED VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMPHREYS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:775-287-0295
Mailing Address - Street 1:2435 PRIMIO CT
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-9589
Mailing Address - Country:US
Mailing Address - Phone:775-287-0295
Mailing Address - Fax:
Practice Address - Street 1:9120 DOUBLE DIAMOND PKWY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4842
Practice Address - Country:US
Practice Address - Phone:775-391-6433
Practice Address - Fax:775-391-6450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty