Healthcare Provider Details

I. General information

NPI: 1265578751
Provider Name (Legal Business Name): ARMISA TONGSON CULLENS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ARMISA CULANCULAN TONGSON M.D.

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 CARONDELET DR SUITE 303
KANSAS CITY MO
64114-4855
US

IV. Provider business mailing address

14811 W 81ST PL
LENEXA KS
66215-4292
US

V. Phone/Fax

Practice location:
  • Phone: 816-941-0440
  • Fax: 816-941-9966
Mailing address:
  • Phone: 816-941-0440
  • Fax: 816-941-9966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR1J85
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0422532
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: