| Organization Name: | EYE SURGERY CENTER OPTICAL |
| NPI Number: | 1184766438 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM G SELF (OWNER) |
| Mailing Address: | 8402 Clay St Ste.4 Westminster |
| State: | CO US |
| Postal Code: | 800313847 |
| Phone Number: | 3034268812 |
| Fax Number: | 3036575597 |
| NPI Enumeration Date: | 02/13/2007 |
| NPI Last Update Date: | 04/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | 20828 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |