Provider Demographics
NPI:1205359627
Name:SPEER, DANIEL WARREN
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:WARREN
Last Name:SPEER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 DEMONBREUN ST.
Mailing Address - Street 2:APT 1114
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:270-302-9464
Mailing Address - Fax:
Practice Address - Street 1:3904 HILLSBORO PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215
Practice Address - Country:US
Practice Address - Phone:615-292-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3392152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist