Healthcare Provider Details

I. General information

NPI: 1164254090
Provider Name (Legal Business Name): VEIN-ITY VEIN CARE CENTERS OF KANSAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 S FOUNTAIN DR
OLATHE KS
66061-7205
US

IV. Provider business mailing address

1337 S FOUNTAIN DR
OLATHE KS
66061-7205
US

V. Phone/Fax

Practice location:
  • Phone: 913-717-5938
  • Fax:
Mailing address:
  • Phone: 913-717-5938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. COURTNYE WALKER
Title or Position: OWNER
Credential: MD
Phone: 843-324-8551