Healthcare Provider Details

I. General information

NPI: 1255364725
Provider Name (Legal Business Name): 20/20 EYE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10123 CHERRY LN
LENEXA KS
66220-9763
US

IV. Provider business mailing address

10123 CHERRY LN
LENEXA KS
66220-9763
US

V. Phone/Fax

Practice location:
  • Phone: 913-254-7456
  • Fax: 913-254-9613
Mailing address:
  • Phone: 913-254-7456
  • Fax: 913-254-9613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. DEANNA J. POWELL
Title or Position: MEMBER LLC/OPTOMETRIST
Credential: O.D.
Phone: 913-254-7456