Provider Demographics
NPI:1316026891
Name:DAN T SPEIR OD PA
Entity Type:Organization
Organization Name:DAN T SPEIR OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SPEIR
Authorized Official - Suffix:
Authorized Official - Credentials:OPTOMETRIST
Authorized Official - Phone:870-994-2775
Mailing Address - Street 1:PO BOX 59
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542
Mailing Address - Country:US
Mailing Address - Phone:870-994-2775
Mailing Address - Fax:870-994-3032
Practice Address - Street 1:1238 HWY 62 412
Practice Address - Street 2:STE B
Practice Address - City:HARDY
Practice Address - State:AR
Practice Address - Zip Code:72542
Practice Address - Country:US
Practice Address - Phone:870-994-2775
Practice Address - Fax:870-994-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2181152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR15370000040OtherQUAL CHOICE
T20234Medicare UPIN
AR15370000040OtherQUAL CHOICE