Provider Demographics
NPI:1568574093
Name:HOWARDS OPTICAL INC
Entity Type:Organization
Organization Name:HOWARDS OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:K
Authorized Official - Last Name:NORDYKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-721-5204
Mailing Address - Street 1:10240 W 13TH ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-4377
Mailing Address - Country:US
Mailing Address - Phone:316-721-5204
Mailing Address - Fax:316-685-0897
Practice Address - Street 1:10240 W 13TH ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-4377
Practice Address - Country:US
Practice Address - Phone:316-721-5204
Practice Address - Fax:316-685-0897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0392490001Medicare NSC