Provider Demographics
NPI:1841284296
Name:VEERAPANENI, RADHIKA (OD)
Entity type:Individual
Prefix:MRS
First Name:RADHIKA
Middle Name:
Last Name:VEERAPANENI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:RADHIKA
Other - Middle Name:
Other - Last Name:PAVULURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3801 DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64130-2807
Mailing Address - Country:US
Mailing Address - Phone:816-922-7645
Mailing Address - Fax:816-922-7617
Practice Address - Street 1:3801 DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64130-2807
Practice Address - Country:US
Practice Address - Phone:816-923-5800
Practice Address - Fax:816-922-7617
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1607152W00000X
MO2001019373152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO315883702Medicaid
B68C216Medicare ID - Type Unspecified
MO315883702Medicaid