Provider Demographics
NPI:1457566143
Name:EYECARE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:EYECARE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-221-4811
Mailing Address - Street 1:702 W DRAKE RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5563
Mailing Address - Country:US
Mailing Address - Phone:970-221-4811
Mailing Address - Fax:970-221-4815
Practice Address - Street 1:702 W DRAKE RD BLDG B
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5563
Practice Address - Country:US
Practice Address - Phone:970-221-4811
Practice Address - Fax:970-221-4815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04011664Medicaid
COCF0003Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER