MEDICARE: ERIC J CROSS OD LLC

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	:	1366272130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIC J CROSS OD LLC

Provider Business Mailing Address
First Line	:	8499 E LOWRY BLVD APT 310
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80230-7266
Country	:	US
Telephone Number	:	219-229-4899
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 16TH ST STE 524
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-2921
Country	:	US
Telephone Number	:	303-534-8811
Fax Number	:	303-825-0109

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	ERIC CROSS
Credential	:	OD
Telephone Number	:	219-229-4899

Provider Enumeration Date	:	08/06/2024
Last Update Date	:	08/06/2024

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