| T.p. Children & Teens Care | |
|
6400 Prospect Ave Suite # 208 Kansas City MO 64132-1100 | |
| (816) 812-3512 | |
| Not Available |
| Full Name | T.p. Children & Teens Care |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 6400 Prospect Ave, Kansas City, Missouri |
| Authorized Official Name and Position | Tasanaporn Pitiyanuvath (OWNER) |
| Authorized Official Contact | 8168123512 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| T.p. Children & Teens Care Po Box 7862 Overland Park KS 66207-0862 Ph: (816) 812-3512 | T.p. Children & Teens Care 6400 Prospect Ave Suite # 208 Kansas City MO 64132-1100 Ph: (816) 812-3512 |
| NPI Number | 1588896526 |
|---|---|
| Provider Enumeration Date | 08/09/2009 |
| Last Update Date | 05/22/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588896526 | NPI | - | NPPES |
| 201583416 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 33971 (Missouri) | Primary |
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