Healthcare Provider Details

I. General information

NPI: 1740119023
Provider Name (Legal Business Name): CASTLE ROCK EYEWEAR, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

856 W HAPPY CANYON RD STE 110
CASTLE ROCK CO
80108-3909
US

IV. Provider business mailing address

856 W HAPPY CANYON RD STE 110
CASTLE ROCK CO
80108-3909
US

V. Phone/Fax

Practice location:
  • Phone: 303-663-2034
  • Fax: 303-663-3428
Mailing address:
  • Phone: 303-663-2034
  • Fax: 303-663-3428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE MATTOX
Title or Position: PRINCIPAL
Credential: DO
Phone: 303-663-2034