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General NPI Number Information
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NPI Number | 1467796292
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Entity Type | Organization
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Legal Business Name | REID OPTOMETRY, PC
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Dates
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Enumeration Date | 11/16/2012
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 3745 DACORO LN STE 100
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City | CASTLE ROCK
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State | CO
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Zip | 80109-2514
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Country | US
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Telephone | 303-660-6005
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Fax | 303-660-6095
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Provider Business Mailing Address
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Address Line | 3745 DACORO LN STE 100
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City | CASTLE ROCK
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State | CO
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Zip | 80109-2514
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Country | US
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Telephone | 303-660-6005
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Fax | 303-660-6095
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Authorized Official
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Title or Position | PRESIDENT/ OPTOMETRIST
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Name | DR. RYAN THOMAS REID
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Credential | O.D.
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Telephone | 303-660-6005
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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 | 2795
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License Number State | CO
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