Provider Demographics
NPI:1518419290
Name:URBAN EYES, PC
Entity type:Organization
Organization Name:URBAN EYES, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERBOLSHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-932-8007
Mailing Address - Street 1:8146 S 96TH ST
Mailing Address - Street 2:STE. 400
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-3187
Mailing Address - Country:US
Mailing Address - Phone:402-934-2034
Mailing Address - Fax:
Practice Address - Street 1:8146 S 96TH ST
Practice Address - Street 2:STE. 400
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-3187
Practice Address - Country:US
Practice Address - Phone:402-934-2034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:URBAN EYES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1217152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty