1740386606 NPI number — OMAHA EYE & LASER INSTITUTE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740386606 NPI number — OMAHA EYE & LASER INSTITUTE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OMAHA EYE & LASER INSTITUTE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740386606
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11606 NICHOLAS STREET,
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68154-4486
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-898-3818
Provider Business Mailing Address Fax Number:
402-493-8341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
755 FALLBROOK BLVD
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68521-4637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-898-3818
Provider Business Practice Location Address Fax Number:
402-493-8341
Provider Enumeration Date:
09/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LIU
Authorized Official First Name:
JESSICA
Authorized Official Middle Name:
LILOONG
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
402-968-0853

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CH8149 . This is a "RR MEDICARE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




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