Provider Demographics
NPI:1255399499
Name:TRIAD EYE ASSOCIATES OF HIGH POINT OD PA
Entity type:Organization
Organization Name:TRIAD EYE ASSOCIATES OF HIGH POINT OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF INSURANCE
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-687-7730
Mailing Address - Street 1:PO BOX 4370
Mailing Address - Street 2:
Mailing Address - City:ARCHDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27263-4370
Mailing Address - Country:US
Mailing Address - Phone:336-886-7500
Mailing Address - Fax:336-886-7502
Practice Address - Street 1:6425 OLD PLANK RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3277
Practice Address - Country:US
Practice Address - Phone:336-886-7500
Practice Address - Fax:336-886-7502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC016XMOtherBCBS/NC
NC5900276Medicaid
NC016XMOtherBCBS/NC
NC2345172Medicare ID - Type UnspecifiedMEDICARE