Provider Demographics
NPI:1023522661
Name:MILLARD FAMILY EYECARE, P.C.
Entity type:Organization
Organization Name:MILLARD FAMILY EYECARE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-884-6841
Mailing Address - Street 1:12660 Q ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-3332
Mailing Address - Country:US
Mailing Address - Phone:402-896-3300
Mailing Address - Fax:402-896-5931
Practice Address - Street 1:2510 S 171ST CT
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2394
Practice Address - Country:US
Practice Address - Phone:402-330-3063
Practice Address - Fax:402-334-4418
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILLARD FAMILY EYECARE, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty