Individual
DR. GLEN C PATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
9401 N OAK TRFY, STE 200, KANSAS CITY, MO 64155-2233
(816) 478-1230
(816) 478-4413
Mailing address
4801 S CLIFF AVE, SUITE 100, INDEPENDENCE, MO 64055-7015
(816) 478-1230
(816) 478-4413
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2004017580
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00167226
RAILROAD MEDICARE
—
Enumeration date
08/23/2005
Last updated
12/06/2007
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