Basic Information
| Provider Information | |||||||||
| NPI: | 1093207177 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACUITY EYECARE HOLDINGS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4835 LBJ | ||||||||
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| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752446005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143969424 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1685 S COLORADO BLVD UNIT O | ||||||||
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| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802224011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037576747 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2018 | ||||||||
| LastUpdateDate: | 06/04/2018 | ||||||||
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| AuthorizedOfficialLastName: | ALLISON | ||||||||
| AuthorizedOfficialFirstName: | MELISSA | ||||||||
| AuthorizedOfficialMiddleName: | K. | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF MANAGED CARE | ||||||||
| AuthorizedOfficialTelephone: | 6184629818 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.