Provider Demographics
NPI:1699956888
Name:LANDIS EYE CARE PLLC
Entity type:Organization
Organization Name:LANDIS EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-621-8391
Mailing Address - Street 1:2110 W WALNUT ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3297
Mailing Address - Country:US
Mailing Address - Phone:479-621-8391
Mailing Address - Fax:479-621-0962
Practice Address - Street 1:2110 W WALNUT ST
Practice Address - Street 2:SUITE 4
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3297
Practice Address - Country:US
Practice Address - Phone:479-621-8391
Practice Address - Fax:479-621-0962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2595152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty