Provider Demographics
NPI:1902143092
Name:LANG FAMILY EYE CARE LLC
Entity type:Organization
Organization Name:LANG FAMILY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:262-923-7073
Mailing Address - Street 1:15855 W NATIONAL AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-5159
Mailing Address - Country:US
Mailing Address - Phone:262-923-7073
Mailing Address - Fax:
Practice Address - Street 1:15855 W NATIONAL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-5159
Practice Address - Country:US
Practice Address - Phone:262-923-7073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3268-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty