Provider Demographics
NPI:1093932311
Name:RIOS, MASON, & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:RIOS, MASON, & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARORITY PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:G
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:316-796-0002
Mailing Address - Street 1:PO BOX 36
Mailing Address - Street 2:
Mailing Address - City:COLWICH
Mailing Address - State:KS
Mailing Address - Zip Code:67030-0036
Mailing Address - Country:US
Mailing Address - Phone:316-796-0002
Mailing Address - Fax:
Practice Address - Street 1:136 W WICHITA AVE
Practice Address - Street 2:
Practice Address - City:COLWICH
Practice Address - State:KS
Practice Address - Zip Code:67030-0036
Practice Address - Country:US
Practice Address - Phone:316-796-0002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1442152W00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS065136OtherBLUE CROSS
KS5955060002Medicare NSC
KS065136OtherBLUE CROSS