Provider Demographics
NPI:1881661080
Name:VACHAL, EVA (MD)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:VACHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1876
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-1876
Mailing Address - Country:US
Mailing Address - Phone:316-385-8428
Mailing Address - Fax:316-652-0340
Practice Address - Street 1:401 E SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5679
Practice Address - Country:US
Practice Address - Phone:620-272-2222
Practice Address - Fax:316-652-0340
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0417092207ZP0101X, 207ZP0102X, 207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100192910AMedicaid
KS002058OtherBCBS
KS100198740AMedicaid
220016733OtherRAILROAD MEDICARE
220016733OtherRAILROAD MEDICARE
KS002058OtherBCBS