Provider Demographics
NPI:1184947129
Name:LOUIS C MANUEL, M.D. EYE SERVICES, INC.
Entity type:Organization
Organization Name:LOUIS C MANUEL, M.D. EYE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:MANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-363-4700
Mailing Address - Street 1:1734 E 63RD ST
Mailing Address - Street 2:STE 501
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-3543
Mailing Address - Country:US
Mailing Address - Phone:816-363-4700
Mailing Address - Fax:816-363-3817
Practice Address - Street 1:1734 E 63RD ST
Practice Address - Street 2:STE 501
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-3543
Practice Address - Country:US
Practice Address - Phone:816-363-4700
Practice Address - Fax:816-363-3817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3701261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200044105Medicaid
MO181077454OtherRAILROAD MEDICARE
C50094OtherUPIN
MO0001153Medicare PIN