Provider Demographics
NPI:1659755239
Name:MUILLER, LISA A (OD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:A
Last Name:MUILLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10120 W 119TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1600
Mailing Address - Country:US
Mailing Address - Phone:913-339-9090
Mailing Address - Fax:913-339-6417
Practice Address - Street 1:10120 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1600
Practice Address - Country:US
Practice Address - Phone:913-339-9090
Practice Address - Fax:913-339-6417
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2011152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist