MEDICARE: DR. JARED TORRES OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2069	KS

General Provider Information

NPI Number	:	1699205088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARED TORRES OD

Provider Business Mailing Address
First Line	:	102 SYDNEE LN
Second Line	:
City	:	HOLCOMB
State	:	KS
Zip	:	67851-9729
Country	:	US
Telephone Number	:	620-521-9791
Fax Number	:

Provider Business Practice Location Address
First Line	:	3101 E KANSAS AVE STE 9
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-6994
Country	:	US
Telephone Number	:	620-272-9667
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2017
Last Update Date	:	06/18/2017

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