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General NPI Number Information
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NPI Number | 1922608751
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Entity Type | Organization
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Legal Business Name | ABBA EYE CARE PC
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Dates
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Enumeration Date | 10/30/2020
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Last Update Date | 01/11/2021
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Provider Practice Location Address
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Address Line | 5640 S PARKER RD
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City | AURORA
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State | CO
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Zip | 80015-1110
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Country | US
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Telephone | 303-369-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 E CAMPBELL RD STE 108
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City | RICHARDSON
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State | TX
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Zip | 75081-1963
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Country | US
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Telephone | 314-741-8183
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | CATHY L SHORT
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Credential |
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Telephone | 618-462-9818
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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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