Provider Demographics
NPI:1225492242
Name:KYRA L. FERRIGAN, O.D. PA
Entity Type:Organization
Organization Name:KYRA L. FERRIGAN, O.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYRA
Authorized Official - Middle Name:LIJA
Authorized Official - Last Name:FERRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:806-382-3961
Mailing Address - Street 1:11000 CCC LOOP
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-5619
Mailing Address - Country:US
Mailing Address - Phone:806-382-3961
Mailing Address - Fax:
Practice Address - Street 1:1900 SE 34TH AVE UNIT 250
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79118-7782
Practice Address - Country:US
Practice Address - Phone:806-331-6150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5328TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty