Provider Demographics
NPI:1578099297
Name:SPRING CREEK EYE CARE, PLLC
Entity Type:Organization
Organization Name:SPRING CREEK EYE CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-223-5030
Mailing Address - Street 1:3100 S COLLEGE AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2643
Mailing Address - Country:US
Mailing Address - Phone:970-223-5030
Mailing Address - Fax:
Practice Address - Street 1:3100 S COLLEGE AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2643
Practice Address - Country:US
Practice Address - Phone:970-223-5030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LORENA DE LA GARZA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO003281152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty