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Organization

WAREN OPTOMETRY

Active
Other names
Waren Optometry
Organization subpart
No

Provider details

NPI number
Authorized official
J WESLEY WAREN O.D. (MANAGING MEMBER)
(316) 729-8600
Entity
Organization

Contact information

Practice address
2121 N TYLER RD, SUITE 302, WICHITA, KS 67212-4920
(316) 729-8600
(316) 773-3160
Mailing address
2121 N TYLER RD, SUITE 302, WICHITA, KS 67212-4900
(316) 729-8600
(316) 773-3160

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1389-3
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
065095
BLUE CROSS/BLUE SHIELD OF KANSAS
KS
01
1770613721
GROUP NPI
KS
Enumeration date
03/07/2007
Last updated
09/10/2014
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