Provider Demographics
NPI:1205390101
Name:TCC OPTOMETRY INC
Entity Type:Organization
Organization Name:TCC OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLASE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-431-8887
Mailing Address - Street 1:1780 KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-2819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6280 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-5056
Practice Address - Country:US
Practice Address - Phone:303-431-8887
Practice Address - Fax:303-431-8992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty