Healthcare Provider Details

I. General information

NPI: 1366630287
Provider Name (Legal Business Name): TEKWANI VISION CENTER ,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9911 KENNERLY RD SUITE A
SAINT LOUIS MO
63128-2700
US

IV. Provider business mailing address

9911 KENNERLY RD SUITE A
SAINT LOUIS MO
63128-2700
US

V. Phone/Fax

Practice location:
  • Phone: 314-842-2020
  • Fax: 314-842-1407
Mailing address:
  • Phone: 314-842-2020
  • Fax: 314-842-1407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. HIRALAL TURSHAMAL TEKWANI
Title or Position: OPHTHALMOLOGIST
Credential: M.D.
Phone: 314-842-2020