Provider Demographics
NPI:1285235358
Name:HALL FAMILY EYECARE LLC
Entity type:Organization
Organization Name:HALL FAMILY EYECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARRAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAKSIN-HALL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:316-208-7856
Mailing Address - Street 1:2107 S SENECA ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-4222
Mailing Address - Country:US
Mailing Address - Phone:316-264-7300
Mailing Address - Fax:316-264-3237
Practice Address - Street 1:2107 S SENECA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-4222
Practice Address - Country:US
Practice Address - Phone:316-264-7300
Practice Address - Fax:316-264-3237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-05
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty