Provider Demographics
NPI:1891046652
Name:SAN LUIS VALLEY EYE CARE LLC
Entity Type:Organization
Organization Name:SAN LUIS VALLEY EYE CARE LLC
Other - Org Name:EXCHANGE OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MICHEAL
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:719-992-2121
Mailing Address - Street 1:PO BOX 1898
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-1898
Mailing Address - Country:US
Mailing Address - Phone:719-992-2121
Mailing Address - Fax:719-993-0155
Practice Address - Street 1:3333 CLARK ST
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-2050
Practice Address - Country:US
Practice Address - Phone:719-298-1393
Practice Address - Fax:719-298-1393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT2902152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty