Organization
EYE SURGERY CENTER OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM G SELF JR. M.D (OWNER)
(303) 426-8812
Entity
Organization
Contact information
Practice address
8402 CLAY ST, STE.4, WESTMINSTER, CO 80031-3847
(303) 426-8812
(303) 657-5597
Mailing address
8402 CLAY ST, STE.4, WESTMINSTER, CO 80031-3847
(303) 426-8812
(303) 657-5597
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
CO
332H00000X
Eyewear Supplier
20828
CO
Other
Enumeration date
02/13/2007
Last updated
07/21/2022
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