Provider Demographics
NPI:1629160312
Name:SENSATIONAL EYES VISION CLINIC
Entity Type:Organization
Organization Name:SENSATIONAL EYES VISION CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HIMEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-604-1060
Mailing Address - Street 1:1280 CENTAUR VILLAGE DR
Mailing Address - Street 2:#2
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3175
Mailing Address - Country:US
Mailing Address - Phone:303-604-1060
Mailing Address - Fax:720-890-8153
Practice Address - Street 1:1280 CENTAUR VILLAGE DR
Practice Address - Street 2:#2
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3175
Practice Address - Country:US
Practice Address - Phone:303-604-1060
Practice Address - Fax:720-890-8153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1403261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center