NPI 1154421402 · live from the CMS NPI Registry
Beth Bazin, O.D.
Optometrist in Kansas City, MO. National Provider Identifier 1154421402, active.
NPI record
| NPI | 1154421402 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1441 E 104th St, Bldg. 3 - Suite 103, Kansas City, MO 64131 |
| Practice phone | 816-333-1500 |
| Mailing address | 7235 W 79 Street, Overland Park, KS 66204 |
| Enumerated | September 25, 2006 |
| Last updated | August 22, 2024 |
| Sole proprietor | No |
| Other names | Beth Bazin |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | T03320 (MO) |
| Optometrist, Pediatrics | 152WP0200X | T03320 (MO) |
| Optometrist, Vision Therapy | 152WV0400X | T03320 (MO) |
| Optometrist primary | 152W00000X | 2211 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.