Northeast Iowa Optical, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

NORTHEAST IOWA OPTICAL, LLC

Practice address

909 E San Marnan Dr
Waterloo, IA 50702-5611

Phone

(830) 320-3852

Fax

(830) 341-5593

NPI assigned

Jun 9, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Daniel Miller

Title

Owner/Provider

Phone

(830) 320-3852

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1083548853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 E SAN MARNAN DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025611",
            "telephone_number": "830-320-3852",
            "fax_number": "830-341-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E SAN MARNAN DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025611",
            "telephone_number": "830-320-3852",
            "fax_number": "830-341-5593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST IOWA OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "830-320-3852"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Ophthalmology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.