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General NPI Number Information
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NPI Number | 1760661177
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Entity Type | Organization
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Legal Business Name | TROY L BEDINGHAUS OD PA
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 04/15/2016
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Provider Practice Location Address
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Address Line | 11151 E STATE ROAD 70
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-8405
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Country | US
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Telephone | 941-739-5959
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Fax | 941-756-1925
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Provider Business Mailing Address
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Address Line | 11151 E STATE ROAD 70
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-8405
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Country | US
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Telephone | 941-739-5959
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Fax | 941-756-1925
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Authorized Official
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Title or Position | PRESIDENT/OPTOMETRIC PHYSICIAN
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Name | DR. TROY LEE BEDINGHAUS
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Credential | O.D.
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Telephone | 941-739-5959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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