Healthcare Provider Details

I. General information

NPI: 1811495070
Provider Name (Legal Business Name): COLORADO EYE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9835 S PARKER RD
PARKER CO
80134-8815
US

IV. Provider business mailing address

4 GARDEN CTR STE 100
BROOMFIELD CO
80020-7090
US

V. Phone/Fax

Practice location:
  • Phone: 303-841-3937
  • Fax: 303-805-4370
Mailing address:
  • Phone: 303-469-1941
  • Fax: 303-469-6634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE NEAL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 844-377-6468