Provider Demographics
NPI: | 1780165316 |
---|---|
Name: | CLEAR VISION ASSOCIATES PC |
Entity type: | Organization |
Organization Name: | CLEAR VISION ASSOCIATES PC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ESTEBAN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SANDOVAL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OD |
Authorized Official - Phone: | 303-861-2020 |
Mailing Address - Street 1: | 1601 E 19TH AVE STE 4525 |
Mailing Address - Street 2: | |
Mailing Address - City: | DENVER |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80218-1290 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 303-861-2020 |
Mailing Address - Fax: | 720-729-8262 |
Practice Address - Street 1: | 1601 E 19TH AVE STE 4525 |
Practice Address - Street 2: | |
Practice Address - City: | DENVER |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80218-1290 |
Practice Address - Country: | US |
Practice Address - Phone: | 303-861-2020 |
Practice Address - Fax: | 720-729-8262 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | CLEAR VISION ASSOCIATES PC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2018-08-22 |
Last Update Date: | 2025-05-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Single Specialty |