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General NPI Number Information
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NPI Number | 1659213304
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Entity Type | Organization
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Legal Business Name | IES COLORADO PLLC
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Dates
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Enumeration Date | 04/09/2026
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Last Update Date | 04/09/2026
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Provider Practice Location Address
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Address Line | 11900 GRANT ST
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City | NORTHGLENN
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State | CO
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Zip | 80233-1117
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Country | US
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Telephone | 303-812-5095
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3309
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-3309
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Country | US
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Telephone | 317-612-0270
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Fax |
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Authorized Official
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Title or Position | MANAGER, PROVIDER ENROLLMENT
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Name | LAURA CARRIZALES CHAVEZ
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Credential |
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Telephone | 214-214-1278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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