Provider Demographics
NPI:1598930745
Name:CHILDREN'S EYE CARE, P.A.
Entity Type:Organization
Organization Name:CHILDREN'S EYE CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRAVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-491-9123
Mailing Address - Street 1:4601 W 109TH ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1318
Mailing Address - Country:US
Mailing Address - Phone:913-491-9123
Mailing Address - Fax:913-491-6608
Practice Address - Street 1:4601 W 109TH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1318
Practice Address - Country:US
Practice Address - Phone:913-491-9123
Practice Address - Fax:913-491-6608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0417188207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
07379OtherSPECTERA
180012951OtherRAIL ROAD MEDICARE
KS200730638OtherMISSOURI MEDICAID
4465821OtherHEALTHNET
06907178OtherBC/BS
0809553OtherUNITED HEALTHCARE
KS100124250CMedicaid
4001325OtherAETNA
461214OtherCHILDRENS MERCY FAMILY HEALTH PARTNERS
100124250COtherUNICARE
30991OtherPRINCIPAL
2343355017OtherCIGNA
446582OtherCENTRAL STATES
07379OtherSPECTERA
KS200730638OtherMISSOURI MEDICAID