Provider Demographics
NPI:1588615702
Name:EYE SPECIALISTS PC
Entity Type:Organization
Organization Name:EYE SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:R
Authorized Official - Last Name:BARES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-292-6514
Mailing Address - Street 1:1103 GALVIN RD S
Mailing Address - Street 2:SUITE F
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-3002
Mailing Address - Country:US
Mailing Address - Phone:402-682-0580
Mailing Address - Fax:402-292-7122
Practice Address - Street 1:1103 GALVIN RD S
Practice Address - Street 2:SUITE H
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-3002
Practice Address - Country:US
Practice Address - Phone:402-292-6514
Practice Address - Fax:402-292-7122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098193Medicare ID - Type Unspecified
NE098515Medicare ID - Type Unspecified