Healthcare Provider Details

I. General information

NPI: 1790602860
Provider Name (Legal Business Name): ALEXIS GABRIELLE PATIENCE OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 W 104TH AVE STE J
NORTHGLENN CO
80234-4139
US

IV. Provider business mailing address

5792 VISTANCIA DR
PARKER CO
80134-4532
US

V. Phone/Fax

Practice location:
  • Phone: 720-502-3060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.0004226
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: