Four Eyes Optical, Lc

NPI #1164681409 in Overland Park, Kansas

Provider Information

NPI Number: 1164681409
Entity Type: Organization
Organization Name: Four Eyes Optical, Lc
Primary Specialty: Optometrist
Enumeration Date: Jun 2, 2008
Last Updated: Oct 10, 2008

Practice Location

Address: 11232 W 135TH ST
City: Overland Park
State: Kansas
ZIP Code: 66221-9800
Phone: (913) 814-7600

Authorized Official

Name: DR. MAX STEVEN MANCILLAS, O.D.
Title: OWNER
Phone: (913) 814-7600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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