Provider Demographics
NPI:1235729351
Name:DANIEL NOVAK OD PC
Entity Type:Organization
Organization Name:DANIEL NOVAK OD PC
Other - Org Name:PREMIER VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:308-280-0404
Mailing Address - Street 1:1835 MARLENE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-9252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3543 S. 85TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68520
Practice Address - Country:US
Practice Address - Phone:402-986-7856
Practice Address - Fax:402-986-6978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty