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General NPI Number Information
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NPI Number | 1780249011
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Entity Type | Organization
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Legal Business Name | BOEVER FAMILY EYECARE
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Dates
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Enumeration Date | 05/02/2019
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 5801 HIDCOTE DR SUITE 101
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City | LINCOLN
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State | NE
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Zip | 68516
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Country | US
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Telephone | 402-307-5090
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Fax |
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Provider Business Mailing Address
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Address Line | 6032 CROSS CREEK RD
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City | LINCOLN
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State | NE
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Zip | 68516-3779
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Country | US
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Telephone | 402-480-0629
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | JOHN N BOEVER
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Credential | OD
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Telephone | 402-307-5090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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