# OPTOM-EYES,LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Optom-Eye,LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619624632
- **Authorized official:** AMANDA WALLS OD (OWNER)
- **Authorized official phone:** (936) 443-4151

## Contact information

- **Practice address:** 3585 VAN TEYLINGEN DR STE B, COLORADO SPRINGS, CO 80917-4872
- **Practice address phone:** (936) 443-4151
- **Mailing address:** 3585 VAN TEYLINGEN DR STE B, COLORADO SPRINGS, CO 80917-4872
- **Mailing address phone:** (936) 443-4151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/09/2022
- **Last updated:** 03/09/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 351521ZGYB | — | CO |