MEDICARE: POWERS EYE CENTER PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1003767518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POWERS EYE CENTER PLLC

Provider Business Mailing Address
First Line	:	6160 TUTT BLVD STE 220
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-3502
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6160 TUTT BLVD STE 220
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-3502
Country	:	US
Telephone Number	:	719-598-5068
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	CHAD WAGGONER
Credential	:	OD
Telephone Number	:	360-789-0525

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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