Healthcare Provider Details

I. General information

NPI: 1235343765
Provider Name (Legal Business Name): ABBA EYE CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W NORTHERN AVE
PUEBLO CO
81004-3124
US

IV. Provider business mailing address

1200 E CAMPBELL RD STE 108
RICHARDSON TX
75081-1963
US

V. Phone/Fax

Practice location:
  • Phone: 719-542-2222
  • Fax: 719-544-8332
Mailing address:
  • Phone: 314-741-8183
  • Fax: 719-219-0411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARCUS MEYER
Title or Position: OWNER
Credential:
Phone: 719-219-3819