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NPI Code Detail

MEDICARE: CHEYENNE EYE CLINIC, LLC

MEDICARE: CHEYENNE EYE CLINIC, 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
1207W00000XOphthalmology Physician

General Provider Information

NPI Number : 1902390974
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHEYENNE EYE CLINIC, LLC
Provider Business Mailing Address
First Line : 1300 E 20TH ST
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-4021
Country : US
Telephone Number : 307-634-2020
Fax Number : 307-635-6510
Provider Business Practice Location Address
First Line : 1300 E 20TH ST
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-4021
Country : US
Telephone Number : 307-634-2020
Fax Number : 307-635-6510
Authorized Official
Title or Position : VP REVENUE CYCLE MANAGEMENT
Name : LAURA GARCIA
Credential :
Telephone Number : 949-615-9288
Provider Enumeration Date : 06/21/2018
Last Update Date : 12/12/2025

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Directions to “CHEYENNE EYE CLINIC, LLC ” Practice Location

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