Provider Demographics
NPI:1215013206
Name:MEDICAL-SURGICAL EYE CARE, P.A.
Entity Type:Organization
Organization Name:MEDICAL-SURGICAL EYE CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:DWIGHT
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-299-8800
Mailing Address - Street 1:8919 PARALLEL PARKWAY
Mailing Address - Street 2:STE 216
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112
Mailing Address - Country:US
Mailing Address - Phone:913-299-8800
Mailing Address - Fax:913-299-6581
Practice Address - Street 1:8919 PARALLEL PARKWAY
Practice Address - Street 2:STE 216
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112
Practice Address - Country:US
Practice Address - Phone:913-299-8800
Practice Address - Fax:913-299-6581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1411152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0233300001Medicare NSC