Provider Demographics
NPI:1679012058
Name:SUPERIOR EYE CARE P.C.
Entity Type:Organization
Organization Name:SUPERIOR EYE CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HUY
Authorized Official - Middle Name:N
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-438-4386
Mailing Address - Street 1:4700 N 27TH ST
Mailing Address - Street 2:WALMART VISION CENTER
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-1190
Mailing Address - Country:US
Mailing Address - Phone:402-438-4386
Mailing Address - Fax:
Practice Address - Street 1:4700 N 27TH ST
Practice Address - Street 2:WALMART VISION CENTER
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-1190
Practice Address - Country:US
Practice Address - Phone:402-438-4386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1424152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty