=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073421715
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EYE CARE ASSOCIATES OF CO, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2026
-----------------------------------------------------
Last Update Date | 09/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 620 MAIN ST
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80443-5487
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-668-2020
-----------------------------------------------------
Fax | 970-668-0192
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 879
-----------------------------------------------------
City | FORT WASHINGTON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19034-0879
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-523-7999
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR RCM
-----------------------------------------------------
Name | DAVID DEPPEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 937-539-8057
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------