Provider Demographics
NPI:1255786265
Name:LEMAS, DOMINIC (OD)
Entity type:Individual
Prefix:DR
First Name:DOMINIC
Middle Name:
Last Name:LEMAS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 GOODPASTURE ISLAND RD APT 196
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-1534
Mailing Address - Country:US
Mailing Address - Phone:503-740-7480
Mailing Address - Fax:
Practice Address - Street 1:1471 PEARL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4009
Practice Address - Country:US
Practice Address - Phone:541-686-1237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-27
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ORATI-4358152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program