Provider Demographics
NPI:1043886971
Name:LOOK OPTICAL, PC
Entity Type:Organization
Organization Name:LOOK OPTICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MANSUR
Authorized Official - Middle Name:
Authorized Official - Last Name:NURDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-683-4466
Mailing Address - Street 1:PO BOX 800148
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-0148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3130 S PARKER RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3110
Practice Address - Country:US
Practice Address - Phone:303-752-2662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOOK OPTICAL, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty