# DENVER EYE SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457335077
- **Authorized official:** MS. JACKIE BECKER (BILLING MANAGER)
- **Authorized official phone:** (303) 273-8774

## Contact information

- **Practice address:** 13772 DENVER WEST PKWY, BLDG\#55, STE\#120, LAKEWOOD, CO 80401-3139
- **Practice address phone:** (303) 279-6600
- **Practice address fax:** (303) 279-9140
- **Mailing address:** 13772 DENVER WEST PKWY STE 120, LAKEWOOD, CO 80401-3139
- **Mailing address phone:** (303) 279-6600
- **Mailing address fax:** (303) 279-9140

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |
| 261QS0132X | Ophthalmologic Surgery Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/06/2005
- **Last updated:** 05/18/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 04510087 | — | CO |
| 01 | — | 427718 | LEGACY TM | CO |
| 01 | — | 490000347 | RAILROAD MEDICARE | — |
| 01 | — | 803092 | LEGACY RK | CO |
| 01 | — | 803688 | LEGACY NM | CO |
| 01 | — | CK2868 | LEGACY VC | CO |
| 01 | — | CK2878 | LEGACY JS | CO |