Provider Demographics
NPI:1255227369
Name:RESTORATION EYECARE LLC
Entity type:Organization
Organization Name:RESTORATION EYECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN CASC
Authorized Official - Phone:573-441-7070
Mailing Address - Street 1:1410 FORUM KATY PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-6583
Mailing Address - Country:US
Mailing Address - Phone:573-441-7070
Mailing Address - Fax:573-441-2288
Practice Address - Street 1:1410 FORUM KATY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-6583
Practice Address - Country:US
Practice Address - Phone:573-441-7070
Practice Address - Fax:573-441-2288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty