Provider Demographics
NPI:1184097354
Name:URBAN EYECARE AND EYEWEAR. LLC
Entity type:Organization
Organization Name:URBAN EYECARE AND EYEWEAR. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANSINK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:515-223-1000
Mailing Address - Street 1:160 S 68TH ST
Mailing Address - Street 2:SUITE 1107
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8303
Mailing Address - Country:US
Mailing Address - Phone:515-223-1000
Mailing Address - Fax:
Practice Address - Street 1:160 S 68TH ST
Practice Address - Street 2:SUITE 1107
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8303
Practice Address - Country:US
Practice Address - Phone:515-223-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002454152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty