Organization
TASANAPORN PITIYANUVATH, M.D. L.L.C.
Active
Other names
T.P. Children & Teens Care
Organization subpart
No
Provider details
NPI number
Authorized official
TASANAPORN PITIYANUVATH M.D. (OWNER)
(816) 812-3512
Entity
Organization
Contact information
Practice address
6400 PROSPECT AVE, SUITE # 208, KANSAS CITY, MO 64132-1100
(816) 812-3512
Mailing address
PO BOX 7862, OVERLAND PARK, KS 66207-0862
(816) 812-3512
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
33971
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201583416
—
MO
Enumeration date
08/09/2009
Last updated
05/22/2012
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