Healthcare Provider Details
I. General information
NPI: 1295414076
Provider Name (Legal Business Name): LINDSEY ERIN ZAVALA OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/18/2023
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 N MAIN ST
DENISON IA
51442-1373
US
IV. Provider business mailing address
11219 Y ST
OMAHA NE
68137-4658
US
V. Phone/Fax
- Phone: 712-263-2020
- Fax:
- Phone: 402-651-3728
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 1621 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 128697 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: