Provider Demographics
NPI:1114175684
Name:STEINBERG OPTOMETRY, P.C.
Entity Type:Organization
Organization Name:STEINBERG OPTOMETRY, P.C.
Other - Org Name:VISIONS EYE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LOWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-447-8470
Mailing Address - Street 1:4509 WELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3155
Mailing Address - Country:US
Mailing Address - Phone:720-939-4774
Mailing Address - Fax:
Practice Address - Street 1:1933 28TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1100
Practice Address - Country:US
Practice Address - Phone:303-447-8470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2268152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18109829Medicaid
CO315390Medicare PIN