Healthcare Provider Details

I. General information

NPI: 1770336497
Provider Name (Legal Business Name): RACHAEL ANN LUX OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2024
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 E BAYAUD AVE STE 485
DENVER CO
80209-3000
US

IV. Provider business mailing address

3400 E BAYAUD AVE STE 485
DENVER CO
80209-3000
US

V. Phone/Fax

Practice location:
  • Phone: 303-688-3636
  • Fax:
Mailing address:
  • Phone: 303-688-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.0004143
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number13974857-9934
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: