Organization
FAMILY EYE CLINIC & CONTACT LENS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA REESE (RECEPTIONIST)
(952) 934-6926
Entity
Organization
Contact information
Practice address
16550 W 78TH ST STE A, EDEN PRAIRIE, MN 55346-4316
(952) 934-6926
(952) 473-9880
Mailing address
1160 WAYZATA BLVD E, WAYZATA, MN 55391-1963
(952) 934-6926
(952) 934-6926
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01012099
PREFERRED ONE
MN
01
—
16226FA
BLUE CROSS BLUE SHIELD
MN
05
—
6768628-00
—
MN
01
—
CF8810
RAIL ROAD MEDICARE
MN
Enumeration date
09/29/2005
Last updated
07/01/2024
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