Provider Demographics
NPI:1316097413
Name:TKC OPTICAL INC
Entity type:Organization
Organization Name:TKC OPTICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:P
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-252-1519
Mailing Address - Street 1:1700 MARKET LN
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-7373
Mailing Address - Country:US
Mailing Address - Phone:402-371-8900
Mailing Address - Fax:402-371-6040
Practice Address - Street 1:1700 MARKET LN
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-7373
Practice Address - Country:US
Practice Address - Phone:402-371-8900
Practice Address - Fax:402-371-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE21536OtherSPECTERA
NENE1189OtherEYEMED
NE21536OtherSPECTERA