Healthcare Provider Details

I. General information

NPI: 1740386606
Provider Name (Legal Business Name): OMAHA EYE & LASER INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 FALLBROOK BLVD SUITE 205
LINCOLN NE
68521-4637
US

IV. Provider business mailing address

11606 NICHOLAS STREET, SUITE 200
OMAHA NE
68154-4486
US

V. Phone/Fax

Practice location:
  • Phone: 402-898-3818
  • Fax: 402-493-8341
Mailing address:
  • Phone: 402-898-3818
  • Fax: 402-493-8341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JESSICA LILOONG LIU
Title or Position: PRESIDENT
Credential: MD
Phone: 402-968-0853