Provider Demographics
NPI:1891041661
Name:TALABER, ALEXANDRA (OD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:TALABER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S JACKSON ST STE 320
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3134
Mailing Address - Country:US
Mailing Address - Phone:720-408-1400
Mailing Address - Fax:
Practice Address - Street 1:300 S JACKSON ST STE 320
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3134
Practice Address - Country:US
Practice Address - Phone:720-408-1400
Practice Address - Fax:720-408-1437
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010843152W00000X
NY007905152WV0400X
CO3236152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL7235044OtherAETNA
IL0757500001Medicare NSC
IL93658OtherUNITED HEALTH CARE
IL01663706OtherBLUE SHIEL
IL8825444OtherMULTIPLAN
IL210209Medicare PIN