Provider Demographics
NPI:1780182618
Name:SOWASH OPTOMETRY GROUP, P.C.
Entity Type:Organization
Organization Name:SOWASH OPTOMETRY GROUP, P.C.
Other - Org Name:VISIONWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOWASH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-882-8235
Mailing Address - Street 1:PO BOX 848209
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-8209
Mailing Address - Country:US
Mailing Address - Phone:800-340-0129
Mailing Address - Fax:210-524-6587
Practice Address - Street 1:4918B THOMPSON PKWY
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-6425
Practice Address - Country:US
Practice Address - Phone:970-461-1086
Practice Address - Fax:970-461-1283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-25
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier