Provider Demographics
NPI:1801063466
Name:AWAD, ELIAS N
Entity type:Individual
Prefix:MR
First Name:ELIAS
Middle Name:N
Last Name:AWAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 S MUR LEN RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-6106
Mailing Address - Country:US
Mailing Address - Phone:913-782-4080
Mailing Address - Fax:913-829-8505
Practice Address - Street 1:103 S MUR LEN RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-6106
Practice Address - Country:US
Practice Address - Phone:913-782-4080
Practice Address - Fax:913-829-8505
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician