Provider Demographics
NPI:1457967283
Name:LUMI EYE CARE PLLC
Entity type:Organization
Organization Name:LUMI EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:YIP
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-882-8760
Mailing Address - Street 1:3855 GLADE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-4814
Mailing Address - Country:US
Mailing Address - Phone:817-866-6633
Mailing Address - Fax:817-888-8846
Practice Address - Street 1:3855 GLADE ROAD
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034
Practice Address - Country:US
Practice Address - Phone:817-866-6633
Practice Address - Fax:817-888-8846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty