Healthcare Provider Details

I. General information

NPI: 1417376559
Provider Name (Legal Business Name): SUNFLOWER PEDIATRIC EYE CARE & STRABISMUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 OREAD WEST ST STE A
LAWRENCE KS
66049-3844
US

IV. Provider business mailing address

1421 OREAD WEST ST STE A
LAWRENCE KS
66049-3844
US

V. Phone/Fax

Practice location:
  • Phone: 785-856-7732
  • Fax: 785-260-6275
Mailing address:
  • Phone: 785-856-7732
  • Fax: 785-260-6275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician
License Number0432373
License Number StateKS

VIII. Authorized Official

Name: NATALIE MARIE KOEDERITZ
Title or Position: OWNER
Credential:
Phone: 785-856-7732