Provider Demographics
NPI:1639237951
Name:TERRY D. HUSEMAN OD PC
Entity Type:Organization
Organization Name:TERRY D. HUSEMAN OD PC
Other - Org Name:HUSEMAN EYECARE, P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE PROCESSOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIGITTE
Authorized Official - Middle Name:J
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-224-9681
Mailing Address - Street 1:3800 MERLE HAY RD #501
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310
Mailing Address - Country:US
Mailing Address - Phone:515-278-1653
Mailing Address - Fax:515-278-0043
Practice Address - Street 1:3800 MERLE HAY RD #501
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310
Practice Address - Country:US
Practice Address - Phone:515-278-1653
Practice Address - Fax:515-278-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIA1834152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1407838436OtherINDIVIDUAL NPI NUMBER
1043280977OtherINDIVIDUAL NPI
IA1750361176OtherINDIVIDUAL NPI NUMBER
1932189354OtherINDIVIDUAL NPI NUMBER
IA1699745125OtherINDIVIDUAL NPI NUMBER
58491Medicare PIN
IAT00899Medicare UPIN
I20611Medicare PIN
I7677Medicare PIN
1043280977OtherINDIVIDUAL NPI
IAU39235Medicare UPIN
I14744Medicare PIN
IA1407838436OtherINDIVIDUAL NPI NUMBER
I7676Medicare PIN
U92587Medicare UPIN