Healthcare Provider Details

I. General information

NPI: 1700955929
Provider Name (Legal Business Name): OPTICAL OPTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/21/2022
Certification Date: 04/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 N KANSAS AVE SUITE 300
HASTINGS NE
68901
US

IV. Provider business mailing address

715 N KANSAS AVE SUITE 300
HASTINGS NE
68901
US

V. Phone/Fax

Practice location:
  • Phone: 402-462-9009
  • Fax: 402-462-8090
Mailing address:
  • Phone: 402-462-9009
  • Fax: 402-462-8090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateNE

VIII. Authorized Official

Name: DR. PAUL J DIETZE
Title or Position: OWNER
Credential: MD
Phone: 402-462-9009