Provider Demographics
NPI:1386977544
Name:HANSEL FAMILY EYECARE, P.C.
Entity type:Organization
Organization Name:HANSEL FAMILY EYECARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HANSEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:563-386-1950
Mailing Address - Street 1:320 W KIMBERLY RD
Mailing Address - Street 2:STE. #28
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-5920
Mailing Address - Country:US
Mailing Address - Phone:563-386-1950
Mailing Address - Fax:563-386-1021
Practice Address - Street 1:320 W KIMBERLY RD
Practice Address - Street 2:STE. #28
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-5920
Practice Address - Country:US
Practice Address - Phone:563-386-1950
Practice Address - Fax:563-386-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002466261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty