Provider Demographics
NPI:1750533006
Name:FAMILY EYECARE
Entity type:Organization
Organization Name:FAMILY EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHRISTY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:816-221-5939
Mailing Address - Street 1:1905 SWIFT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3421
Mailing Address - Country:US
Mailing Address - Phone:816-221-5939
Mailing Address - Fax:816-221-8705
Practice Address - Street 1:1905 SWIFT AVE
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3421
Practice Address - Country:US
Practice Address - Phone:816-221-5939
Practice Address - Fax:816-221-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-17
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1054-2152W00000X
MO2245152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1619090792OtherBLUE CROSS BLUE SHIELD
MO1750533006OtherUNITED HEALTHCARE
MO1750533006OtherBLUE CROSS / BLUE SHIELD MO - KC
MO1619090792OtherBLUE CROSS BLUE SHIELD
MO1750533006OtherBLUE CROSS / BLUE SHIELD MO - KC