Organization
FAMILY EYECARE CENTER OF DESOTO KANSAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY WAGNER (CLINIC COORDINATOR)
(913) 682-2929
Entity
Organization
Contact information
Practice address
8781 LEXINGTON AVE, DE SOTO, KS 66018-9106
(913) 290-5085
Mailing address
2301 10TH AVE, LEAVENWORTH, KS 66048-4214
(913) 682-2929
(913) 682-2999
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
07/03/2025
Last updated
10/28/2025
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