Organization
FOUR EYES OPTICAL, LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAX STEVEN MANCILLAS O.D. (OWNER)
(913) 814-7600
Entity
Organization
Contact information
Practice address
11232 W 135TH ST, OVERLAND PARK, KS 66221-9800
(913) 814-7600
(913) 814-3906
Mailing address
11232 W 135TH ST, OVERLAND PARK, KS 66221-9800
(913) 814-7600
(913) 814-3906
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12253
KS
Other
Enumeration date
06/02/2008
Last updated
10/10/2008
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