Provider Demographics
NPI:1316203284
Name:VISION PROFESSIONALS OF LEAWOOD, LLC
Entity Type:Organization
Organization Name:VISION PROFESSIONALS OF LEAWOOD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:R
Authorized Official - Last Name:OHDE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:913-526-1441
Mailing Address - Street 1:5020 W. 135TH STREET
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209
Mailing Address - Country:US
Mailing Address - Phone:913-239-9446
Mailing Address - Fax:
Practice Address - Street 1:5020 W. 135TH STREET
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209
Practice Address - Country:US
Practice Address - Phone:913-239-9446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1820152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty