Provider Demographics
NPI:1538280896
Name:KATHY J. LENTZ, M.D. DBA WASHINGTON EYE SURGEONS
Entity Type:Organization
Organization Name:KATHY J. LENTZ, M.D. DBA WASHINGTON EYE SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-239-2008
Mailing Address - Street 1:851 E 5TH ST STE 116
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-3128
Mailing Address - Country:US
Mailing Address - Phone:636-239-2008
Mailing Address - Fax:636-239-4462
Practice Address - Street 1:851 E 5TH ST STE 116
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-3128
Practice Address - Country:US
Practice Address - Phone:636-239-2008
Practice Address - Fax:636-239-4462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5B94174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1144221581OtherINDIVIDUAL NPI NUMBER
MO1144221581OtherINDIVIDUAL NPI NUMBER