=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306044110
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BREWER AND LYONS EYECARE, LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/03/2007
-----------------------------------------------------
Last Update Date | 03/21/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1644 US HIGHWAY 395 N UNIT B-1
-----------------------------------------------------
City | MINDEN
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89423-4320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-783-1111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1538 US HIGHWAY 395 N
-----------------------------------------------------
City | GARDNERVILLE
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89410-5402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-232-2311
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPTOMETRIST
-----------------------------------------------------
Name | DR. SOMER LYONS
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 775-783-1111
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 489
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------