Provider Demographics
NPI:1659356442
Name:DRS HAWKS BESLER & ROGERS OPTOMETRISTS PA
Entity Type:Organization
Organization Name:DRS HAWKS BESLER & ROGERS OPTOMETRISTS PA
Other - Org Name:DRS HAWKS BESLER & ROGERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-341-4508
Mailing Address - Street 1:5703 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2919
Mailing Address - Country:US
Mailing Address - Phone:913-341-4508
Mailing Address - Fax:913-341-4570
Practice Address - Street 1:5703 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66207-2919
Practice Address - Country:US
Practice Address - Phone:913-341-4508
Practice Address - Fax:913-341-4570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO08366026OtherKANSAS CITY BCBS NUMBER
MO08366026OtherKANSAS CITY BCBS NUMBER
KSCJ7427Medicare PIN
KS4840000Medicare PIN
MO08366026OtherKANSAS CITY BCBS NUMBER