Professional Eyecare - Bannister
Optometrist in Kansas City, MO. Organization (NPI-2).
NPI number1245382829
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1245382829
- Entity type
- Organization (NPI-2)
- Legal business name
- Professional Eyecare - Bannister
- Organization subpart
- No
- Enumeration date
- Jan 17, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | TO2880 | MO | Yes |
Practice location
5600 E Bannister Rd Rm 188Kansas City, MO 64192-1000
Phone 816-765-3310 · Fax 816-765-3181
Mailing address
5600 E Bannister Rd Rm 188Kansas City, MO 64192-1000
Phone 816-765-3310 · Fax 816-765-3181
Authorized official
Denise Lorraine Royer
Managed Care Manager
9136960092
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