# HV PUEBLO SOUTH LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Academy Kids Vision
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700247228
- **Authorized official:** MS. SAMANTHA B LEBLANC (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (719) 323-2372

## Contact information

- **Practice address:** 1725 S PUEBLO BLVD, PUEBLO, CO 81005-2103
- **Practice address phone:** (719) 281-2633
- **Practice address fax:** (719) 281-2634
- **Mailing address:** 2221 E BIJOU ST, STE 100, COLORADO SPRINGS, CO 80909
- **Mailing address phone:** (719) 281-2633
- **Mailing address fax:** (719) 281-2634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/10/2016
- **Last updated:** 04/14/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 68820071 | — | CO |