Healthcare Provider Details
I. General information
NPI: 1679303283
Provider Name (Legal Business Name): CLEAR VIEW VISION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/07/2024
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
711 W ABRIENDO AVE
PUEBLO CO
81004-1559
US
IV. Provider business mailing address
711 W ABRIENDO AVE
PUEBLO CO
81004-1559
US
V. Phone/Fax
- Phone: 719-544-9494
- Fax: 719-230-0097
- Phone: 719-544-9494
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WP0200X |
| Taxonomy | Pediatric Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CORY
W.
SMITH
Title or Position: OWNER/OPTOMETRIST
Credential: OD
Phone: 719-544-9494