Provider Demographics
NPI:1871643718
Name:STROHMEYER, KAYCE A (OD)
Entity Type:Individual
Prefix:DR
First Name:KAYCE
Middle Name:A
Last Name:STROHMEYER
Suffix:
Gender:F
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:PO BOX 207158
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-7158
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:1595 DENMARK RD
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-4911
Practice Address - Country:US
Practice Address - Phone:636-584-8989
Practice Address - Fax:636-584-0404
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003026559152WP0200X, 152W00000X
MO2003206559152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO183821OtherBLUE SHIELD PROVIDER #
MO319301628Medicaid
MO0242210001Medicare NSC
MO257339205Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
MO319301628Medicaid
MO257339203Medicare ID - Type UnspecifiedMEDICARE PROVIDER #