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General NPI Number Information
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NPI Number | 1649209586
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Entity Type | Organization
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Legal Business Name | HEART OF AMERICA EYE CARE, PA
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 8800 W 75TH ST STE 140
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City | SHAWNEE MISSION
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State | KS
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Zip | 66204-4001
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Country | US
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Telephone | 913-362-3210
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Fax | 913-362-0407
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Provider Business Mailing Address
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Address Line | 8800 W 75TH ST STE 140
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City | SHAWNEE MISSION
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State | KS
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Zip | 66204-4001
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Country | US
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Telephone | 913-362-3210
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Fax | 913-362-0407
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Authorized Official
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Title or Position | CEO
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Name | BRADLEY RAYMOND KWAPISZESKI
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Credential | MD
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Telephone | 913-362-3210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | KS
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