Basic Information
| Provider Information | |||||||||
| NPI: | 1962445999 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEAR | ||||||||
| FirstName: | REX | ||||||||
| MiddleName: | V | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 271 W 3RD ST N | ||||||||
| Address2: | STE 600 | ||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672021212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166607621 | ||||||||
| FaxNumber: | 3169415075 | ||||||||
| Practice Location | |||||||||
| Address1: | 1919 N AMIDON AVE | ||||||||
| Address2: | STE. 130 | ||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 67203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166607675 | ||||||||
| FaxNumber: | 3168321571 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 05/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 04-21917 | KS | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 55030 | 01 | KS | CIGNA | OTHER | 2360 | 01 | KS | PREFERRED HEALTH SYSTEMS | OTHER | PV56237 | 01 | KS | AMERICAN PSYCH SYSTEMS | OTHER | 056977 | 01 | KS | BLUE CROSS BLUE SHIELD | OTHER |