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General NPI Number Information
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NPI Number | 1366234940
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Entity Type | Organization
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Legal Business Name | CHILDREN'S EYE PHYSICIANS P.C.
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2400 VILLAGE VISTA DR
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City | ERIE
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State | CO
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Zip | 80516-4821
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Country | US
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Telephone | 303-456-9456
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Fax | 303-467-0145
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Provider Business Mailing Address
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Address Line | 4875 WARD RD #600
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-1944
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Country | US
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Telephone | 303-456-9990
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Fax | 303-463-7563
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR/CEO
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Name | LYNETTE BRIDGES
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Credential |
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Telephone | 303-463-5784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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