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General NPI Number Information
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NPI Number | 1750533006
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Entity Type | Organization
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Legal Business Name | FAMILY EYECARE
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Dates
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Enumeration Date | 10/17/2008
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 1905 SWIFT AVE
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3421
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Country | US
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Telephone | 816-221-5939
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Fax | 816-221-8705
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Provider Business Mailing Address
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Address Line | 1905 SWIFT AVE
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3421
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Country | US
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Telephone | 816-221-5939
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Fax | 816-221-8705
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN H CHRISTY
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Credential | O.D.
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Telephone | 816-221-5939
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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 | 1054-2
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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 | 2245
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License Number State | MO
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