Healthcare Provider Details

I. General information

NPI: 1811518004
Provider Name (Legal Business Name): COLLEEN ANNALINA TEJCHMA OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16750 S TOWNSEND AVE
MONTROSE CO
81401-5410
US

IV. Provider business mailing address

16750 S TOWNSEND AVE
MONTROSE CO
81401-5410
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-0841
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT-002492
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3861
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3100
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: