Provider Demographics
NPI:1225222151
Name:COMPLETE EYE CARE, INC.
Entity Type:Organization
Organization Name:COMPLETE EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-404-2020
Mailing Address - Street 1:11480 SHERIDAN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80020-3347
Mailing Address - Country:US
Mailing Address - Phone:303-404-2020
Mailing Address - Fax:303-404-2097
Practice Address - Street 1:11480 SHERIDAN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80020-3347
Practice Address - Country:US
Practice Address - Phone:303-404-2020
Practice Address - Fax:303-404-2097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1738152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO359018Medicare PIN
COU55839Medicare UPIN
COC359008Medicare PIN