Thueson, Bryce Byram
Thueson, Bryce Byram is an sole proprietor health care provider with primary practice located at 76 Professional Plz , Rexburg ID 83440-2047. He recently has 7 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Thueson, Bryce Byram can be contacted via phone (208) 356-4585.Contact Information
Primary practice address
76 Professional Plz
Rexburg ID 83440-2047
Phone: (208) 356-4585
Fax: (208) 356-4587
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-100014 | Idaho |
Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | ODP-100014 | Idaho |
Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | ODP-100014 | Idaho |
Eye and Vision Services Providers / Pediatrics | 152WP0200X | ODP-100014 | Idaho |
Eye and Vision Services Providers / Sports Vision | 152WS0006X | ODP-100014 | Idaho |
Eye and Vision Services Providers / Vision Therapy | 152WV0400X | ODP-100014 | Idaho |
Eye and Vision Services Providers / Occupational Vision | 152WX0102X | ODP-100014 | Idaho |
Profile Details
NPI number | 1144260969 |
---|---|
LBN Legal business name | Thueson, Bryce Byram |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 8th, 2006 |
Last updated | Jul 22nd, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1144260969 | NPPES |
Idaho | Other | ODP-100014 | IDAHO OPTOMETRY LICENSE |
Idaho | Other | 000010146982 | IDAHO OPTOMETRY LICENSE |
Idaho | Other | V631-7 | IDAHO OPTOMETRY LICENSE |
Idaho | MEDICAID | 807155800 | IDAHO OPTOMETRY LICENSE |
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