Healthcare Provider Details

I. General information

NPI: 1326032418
Provider Name (Legal Business Name): CORNEAL CONSULTANTS OF COLORADO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 W MINERAL AVE STE 100
LITTLETON CO
80120-5612
US

IV. Provider business mailing address

1501 W MINERAL AVE STE 100
LITTLETON CO
80120-5612
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-8024
  • Fax: 303-730-6163
Mailing address:
  • Phone: 303-730-8024
  • Fax: 303-730-6163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. MARTIN RIOS
Title or Position: REVENUE MANAGER
Credential:
Phone: 303-730-0404