Provider Demographics
NPI:1982701975
Name:KHAN EYELID AND FACIAL PLASTIC SURGERY LLC
Entity Type:Organization
Organization Name:KHAN EYELID AND FACIAL PLASTIC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:BIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-696-1154
Mailing Address - Street 1:9650 NALL AVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2952
Mailing Address - Country:US
Mailing Address - Phone:913-696-1154
Mailing Address - Fax:913-696-0984
Practice Address - Street 1:9650 NALL AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66207-2952
Practice Address - Country:US
Practice Address - Phone:913-696-1154
Practice Address - Fax:913-696-0984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0421769207W00000X
MO36432207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100155470HMedicaid
MO31669015OtherBCBS
MO31669015OtherBCBS
KS100155470HMedicaid
KS110865Medicare PIN
B99175Medicare UPIN