Provider Demographics
NPI:1699733329
Name:TRIEBEL, BETH (OD)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:
Last Name:TRIEBEL
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 1:2699 86TH ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4309
Mailing Address - Country:US
Mailing Address - Phone:515-270-2490
Mailing Address - Fax:515-270-2494
Practice Address - Street 1:2699 86TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4309
Practice Address - Country:US
Practice Address - Phone:515-270-2490
Practice Address - Fax:515-270-2494
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01965152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA48180OtherBLUE CROSS
IA410035605OtherRAILROAD MEDICARE
IA48180Medicare ID - Type Unspecified
IA48180OtherBLUE CROSS