MEDICARE: CORY T STEED O D PROF CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	NV0440	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00265	OTHER	NV	ANTHEM BCBS GROUP ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235255571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORY T STEED O D PROF CORP

Provider Business Mailing Address
First Line	:	9435 W RUSSELL RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5608
Country	:	US
Telephone Number	:	702-207-2222
Fax Number	:	888-859-4959

Provider Business Practice Location Address
First Line	:	9435 W RUSSELL RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5608
Country	:	US
Telephone Number	:	702-207-2222
Fax Number	:	888-859-4959

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CORY THOMAS STEED
Credential	:	O.D.
Telephone Number	:	702-207-2222

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	08/21/2023

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