Provider Demographics
NPI:1558097675
Name:PIONEER FAMILY EYECARE, PC
Entity Type:Organization
Organization Name:PIONEER FAMILY EYECARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-617-8306
Mailing Address - Street 1:4101 PIONEER WOODS DR STE 102
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7567
Mailing Address - Country:US
Mailing Address - Phone:531-249-5457
Mailing Address - Fax:
Practice Address - Street 1:4101 PIONEER WOODS DR STE 102
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-7567
Practice Address - Country:US
Practice Address - Phone:531-249-5457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty