Basic Information
| Provider Information | |||||||||
| NPI: | 1942403373 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARVADA VISION & EYE CLINIC, P. C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5801 WADSWORTH BLVD | ||||||||
| Address2: | |||||||||
| City: | ARVADA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800035421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034223817 | ||||||||
| FaxNumber: | 3034236317 | ||||||||
| Practice Location | |||||||||
| Address1: | 5801 WADSWORTH BLVD | ||||||||
| Address2: | |||||||||
| City: | ARVADA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800035421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034223817 | ||||||||
| FaxNumber: | 3034236317 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2007 | ||||||||
| LastUpdateDate: | 01/23/2019 | ||||||||
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| AuthorizedOfficialLastName: | CROSS | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3034223817 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1120 | CO | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.