Provider Demographics
NPI:1962871186
Name:KLEIN EYECARE PC
Entity type:Organization
Organization Name:KLEIN EYECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:308-238-4630
Mailing Address - Street 1:18013 DEWEY CIR
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-5670
Mailing Address - Country:US
Mailing Address - Phone:308-238-4630
Mailing Address - Fax:
Practice Address - Street 1:16959 EVANS PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-2388
Practice Address - Country:US
Practice Address - Phone:402-289-0063
Practice Address - Fax:402-289-2253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1346152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty