Provider Demographics
NPI:1528378411
Name:LYMER, TED R II (OD)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:R
Last Name:LYMER
Suffix:II
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1710 BRIARGATE BLVD STE 485
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3461
Mailing Address - Country:US
Mailing Address - Phone:719-266-8473
Mailing Address - Fax:719-266-9443
Practice Address - Street 1:9362 GRAND CORDERA PKWY STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-7007
Practice Address - Country:US
Practice Address - Phone:719-888-4688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT02693152W00000X
COOPT.0003021152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist