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NPI Code Detail

MEDICARE: CASTLE ROCK EYEWEAR, INC

MEDICARE: CASTLE ROCK EYEWEAR, INC
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1740119023
Entity Type Code : Organization
Provider Name (Legal Business Name) : CASTLE ROCK EYEWEAR, INC
Provider Business Mailing Address
First Line : 856 W HAPPY CANYON RD STE 110
Second Line :
City : CASTLE ROCK
State : CO
Zip : 80108-3909
Country : US
Telephone Number : 303-663-2034
Fax Number : 303-663-3428
Provider Business Practice Location Address
First Line : 856 W HAPPY CANYON RD STE 110
Second Line :
City : CASTLE ROCK
State : CO
Zip : 80108-3909
Country : US
Telephone Number : 303-663-2034
Fax Number : 303-663-3428
Authorized Official
Title or Position : PRINCIPAL
Name : CHARLOTTE MATTOX
Credential : DO
Telephone Number : 303-663-2034
Provider Enumeration Date : 05/14/2026
Last Update Date : 05/14/2026

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Directions to “CASTLE ROCK EYEWEAR, INC ” Practice Location

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