Provider Demographics
NPI:1417221813
Name:DAVIDS EYECARE INC
Entity Type:Organization
Organization Name:DAVIDS EYECARE INC
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, DAVIDS EYECARE
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:KOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-763-6466
Mailing Address - Street 1:17255 DAVENPORT ST
Mailing Address - Street 2:SUITE 139
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-4092
Mailing Address - Country:US
Mailing Address - Phone:402-763-6466
Mailing Address - Fax:
Practice Address - Street 1:17255 DAVENPORT ST
Practice Address - Street 2:SUITE 139
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-4092
Practice Address - Country:US
Practice Address - Phone:402-763-6466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty