Provider Demographics
NPI:1518322288
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:316-796-0002
Mailing Address - Street 1:136 W WICHITA AVE
Mailing Address - Street 2:
Mailing Address - City:COLWICH
Mailing Address - State:KS
Mailing Address - Zip Code:67030-9793
Mailing Address - Country:US
Mailing Address - Phone:316-796-0002
Mailing Address - Fax:316-796-0006
Practice Address - Street 1:136 W WICHITA AVE
Practice Address - Street 2:
Practice Address - City:COLWICH
Practice Address - State:KS
Practice Address - Zip Code:67030-9793
Practice Address - Country:US
Practice Address - Phone:316-796-0002
Practice Address - Fax:316-796-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1442-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty