Healthcare Provider Details

I. General information

NPI: 1699816751
Provider Name (Legal Business Name): EYE VISION OPTICAL,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 CHAMPA ST
DENVER CO
80202-2908
US

IV. Provider business mailing address

1551 CHAMPA ST
DENVER CO
80202-2908
US

V. Phone/Fax

Practice location:
  • Phone: 303-534-8811
  • Fax: 303-825-0109
Mailing address:
  • Phone: 303-534-8811
  • Fax: 303-825-0109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number2292093
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License Number2292093
License Number StateCO

VIII. Authorized Official

Name: MR. JAFAR TALYAI
Title or Position: PRESIDENT
Credential: OPTICIAN
Phone: 303-534-8811