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General NPI Number Information
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NPI Number | 1083171425
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Entity Type | Organization
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Legal Business Name | THE EYE CENTER OF GARDEN CITY PA
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 02/21/2019
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Provider Practice Location Address
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Address Line | 3101 E KANSAS AVE STE 9
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City | GARDEN CITY
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State | KS
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Zip | 67846-6994
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Country | US
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Telephone | 620-272-9667
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Fax | 620-260-9548
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Provider Business Mailing Address
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Address Line | 3101 E KANSAS AVE STE 9
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City | GARDEN CITY
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State | KS
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Zip | 67846-6994
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Country | US
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Telephone | 620-272-9667
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Fax | 620-260-9548
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Authorized Official
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Title or Position | CEO
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Name | DR. JARED TORRES
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Credential | OD
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Telephone | 620-521-9791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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