Provider Demographics
NPI:1689654881
Name:STANGA, ROBERT JAMES (OD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:STANGA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11757 W KEN CARYL AVE
Mailing Address - Street 2:STE L
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3719
Mailing Address - Country:US
Mailing Address - Phone:303-904-4555
Mailing Address - Fax:303-933-2981
Practice Address - Street 1:11757 W KEN CARYL AVE
Practice Address - Street 2:STE L
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3719
Practice Address - Country:US
Practice Address - Phone:303-904-4555
Practice Address - Fax:303-933-2981
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1377152W00000X
CO2824152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist