Provider Demographics
NPI:1275908527
Name:HECTOR RIOS OPTOMETRY LLC
Entity Type:Organization
Organization Name:HECTOR RIOS OPTOMETRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:316-522-6311
Mailing Address - Street 1:3040 S SENECA ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67217-3246
Mailing Address - Country:US
Mailing Address - Phone:316-522-6311
Mailing Address - Fax:316-522-6599
Practice Address - Street 1:3040 S SENECA ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67217-3246
Practice Address - Country:US
Practice Address - Phone:316-522-6311
Practice Address - Fax:316-522-6599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1442-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty