Provider Demographics
NPI:1396775359
Name:FERRIGAN, KYRA LIJA (OD)
Entity type:Individual
Prefix:DR
First Name:KYRA
Middle Name:LIJA
Last Name:FERRIGAN
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 1:11000 CCC LOOP
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-5619
Mailing Address - Country:US
Mailing Address - Phone:806-382-3961
Mailing Address - Fax:
Practice Address - Street 1:1900 SE 34TH AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79118-7771
Practice Address - Country:US
Practice Address - Phone:806-331-6150
Practice Address - Fax:806-410-0567
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5328TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81345QOtherBCBS
TX132372101OtherFIRSTCARE/SOUTHWEST
TX81345QOtherBCBS