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General NPI Number Information
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NPI Number | 1467578278
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Entity Type | Organization
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Legal Business Name | FAMILY EYE CLINIC, PC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/12/2016
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Provider Practice Location Address
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Address Line | 6881 S YOSEMITE ST
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City | CENTENNIAL
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State | CO
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Zip | 80112-1406
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Country | US
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Telephone | 303-393-8378
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Fax | 720-872-4902
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Provider Business Mailing Address
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Address Line | 6881 S YOSEMITE ST
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City | CENTENNIAL
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State | CO
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Zip | 80112-1406
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Country | US
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Telephone | 303-393-8378
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Fax | 720-872-4902
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. SHAWN M. DEMOSS
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Credential |
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Telephone | 303-393-8378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number |
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License Number State |
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