Provider Demographics
NPI:1467846568
Name:BRENTWOOD EYECARE, LLC
Entity Type:Organization
Organization Name:BRENTWOOD EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:615-504-1412
Mailing Address - Street 1:5554 FRANKLIN PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37220-2131
Mailing Address - Country:US
Mailing Address - Phone:615-373-4747
Mailing Address - Fax:
Practice Address - Street 1:5554 FRANKLIN PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37220-2131
Practice Address - Country:US
Practice Address - Phone:615-373-4747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2422152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty