=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811436710
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOPEKA EYE ASSOCIATES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2017
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2600 NW ROCHESTER RD
-----------------------------------------------------
City | TOPEKA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66617-1270
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-234-7851
-----------------------------------------------------
Fax | 785-234-7852
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3989 FOXRIDGE DR
-----------------------------------------------------
City | MANHATTAN
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66502-8703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-234-7851
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PART OWNER/OPTOMETRIST
-----------------------------------------------------
Name | ANNIE M MOSIER ESLIT
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 785-410-2992
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 1986
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 2027
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------