Provider Demographics
NPI:1962363374
Name:TEAL MEDICAL PRACTICE OF KANSAS, P.A.
Entity type:Organization
Organization Name:TEAL MEDICAL PRACTICE OF KANSAS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-945-1742
Mailing Address - Street 1:1012 TORNEY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94129-1704
Mailing Address - Country:US
Mailing Address - Phone:415-294-0775
Mailing Address - Fax:855-510-5805
Practice Address - Street 1:112 SW 7TH ST STE 3C
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603-3858
Practice Address - Country:US
Practice Address - Phone:415-294-0775
Practice Address - Fax:855-510-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty