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General NPI Number Information
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NPI Number | 1811932353
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Entity Type | Organization
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Legal Business Name | WICHITA VISION INSTITUTE P.A.
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 01/24/2011
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Provider Practice Location Address
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Address Line | 2552 N MAIZE RD SUITE 200
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City | WICHITA
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State | KS
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Zip | 67205-7341
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Country | US
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Telephone | 316-773-6400
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Fax | 316-773-6401
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Provider Business Mailing Address
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Address Line | 2552 N MAIZE RD SUITE 200
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City | WICHITA
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State | KS
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Zip | 67205-7341
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Country | US
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Telephone | 316-773-6400
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Fax | 316-773-6401
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Authorized Official
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Title or Position | PRESIDENT, WICHITA VISION INSTITUTE
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Name | REENA N. PATEL
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Credential | M.D.
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Telephone | 316-773-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 04-38059
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License Number State | KS
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