Provider Demographics
NPI:1720454986
Name:BARAJAS, CAROLINE BUNDRICK (OD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:BUNDRICK
Last Name:BARAJAS
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 1:4 GARDEN CTR STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7090
Mailing Address - Country:US
Mailing Address - Phone:303-469-1941
Mailing Address - Fax:303-469-6634
Practice Address - Street 1:4 GARDEN CTR STE 100
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7090
Practice Address - Country:US
Practice Address - Phone:303-469-1941
Practice Address - Fax:303-469-6634
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003455152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPENDINGMedicaid
COPENDINGOtherMEDICARE