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General NPI Number Information
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NPI Number | 1104072107
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Entity Type | Individual
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Provider Name | TYLER OHDE O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 5020 W. 135TH STREET
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City | LEAWOOD
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State | KS
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Zip | 66209
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Country | US
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Telephone | 913-239-9446
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Fax |
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Provider Business Mailing Address
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Address Line | 10826 N RICHMOND AVE
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City | KANSAS CITY
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State | MO
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Zip | 64157-6800
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Country | US
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Telephone | 913-526-1441
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1820
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2008024282
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License Number State | MO
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