Provider Demographics
NPI:1245761576
Name:DAU FAMILY EYE CARE, PLLC
Entity Type:Organization
Organization Name:DAU FAMILY EYE CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:DAU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-540-0648
Mailing Address - Street 1:132 EVEREST LN
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-4090
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132 EVEREST LN
Practice Address - Street 2:SUITE 5
Practice Address - City:SAINT JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-4090
Practice Address - Country:US
Practice Address - Phone:402-540-0648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 5048152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty