Provider Demographics
NPI:1003532755
Name:UNDERWOOD EYE CARE, PC
Entity Type:Organization
Organization Name:UNDERWOOD EYE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-739-6489
Mailing Address - Street 1:22 S BEECH ST
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-3744
Mailing Address - Country:US
Mailing Address - Phone:970-565-7195
Mailing Address - Fax:970-565-7171
Practice Address - Street 1:22 S BEECH ST
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-3744
Practice Address - Country:US
Practice Address - Phone:970-739-6489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty