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General NPI Number Information
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NPI Number | 1336172055
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Entity Type | Organization
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Legal Business Name | SOWASH OPTOMETRY GROUP PC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 355 S WADSWORTH BLVD SUITE D
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City | LAKEWOOD
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State | CO
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Zip | 80226-3136
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Country | US
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Telephone | 720-962-6906
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 848209
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City | DALLAS
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State | TX
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Zip | 75284-8209
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Country | US
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Telephone | 210-524-6771
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Fax | 210-524-6587
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Authorized Official
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Title or Position | MANAGER OF NETWORK MANAGEMENT
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Name | DOLSIE D MCDONALD
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Credential |
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Telephone | 726-444-4078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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