Provider Demographics
NPI:1023099496
Name:PAULA POSTMA, P.C.
Entity type:Organization
Organization Name:PAULA POSTMA, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:POSTMA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-443-2020
Mailing Address - Street 1:2885 AURORA AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2250
Mailing Address - Country:US
Mailing Address - Phone:303-443-2020
Mailing Address - Fax:303-444-2030
Practice Address - Street 1:2885 AURORA AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2250
Practice Address - Country:US
Practice Address - Phone:303-443-2020
Practice Address - Fax:303-444-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1966152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC801595OtherMEDICARE PTAN
COC801595OtherMEDICARE PTAN
CO801596Medicare ID - Type Unspecified