Provider Demographics
NPI:1780249011
Name:BOEVER FAMILY EYECARE
Entity type:Organization
Organization Name:BOEVER FAMILY EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:N
Authorized Official - Last Name:BOEVER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-307-5090
Mailing Address - Street 1:6032 CROSS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3779
Mailing Address - Country:US
Mailing Address - Phone:402-480-0629
Mailing Address - Fax:
Practice Address - Street 1:5801 HIDCOTE DR SUITE 101
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516
Practice Address - Country:US
Practice Address - Phone:402-307-5090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty