Provider Demographics
NPI:1225251788
Name:BOYACE J. HOLLAND, O.D.
Entity Type:Organization
Organization Name:BOYACE J. HOLLAND, O.D.
Other - Org Name:COLLEGE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BOYACE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-444-3092
Mailing Address - Street 1:1310 COLLEGE AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-7324
Mailing Address - Country:US
Mailing Address - Phone:303-444-3092
Mailing Address - Fax:303-938-0572
Practice Address - Street 1:1310 COLLEGE AVE STE 310
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-7324
Practice Address - Country:US
Practice Address - Phone:303-444-3092
Practice Address - Fax:303-938-0572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO685152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO438208Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER