Organization
RETINA CONSULTANTS OF SOUTHERN COLORADO PLLC
Active
Organization
RETINA CONSULTANTS OF SOUTHERN COLORADO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE DARLENE BEAL (OPERATIONS DIRECTOR)
(719) 473-9595
Entity
Organization
Contact information
Practice address
3711 PARKER BLVD, PUEBLO, CO 81008-2278
(719) 473-9595
(719) 227-0669
Mailing address
2770 N UNION BLVD STE 140, COLORADO SPRINGS, CO 80909-1183
(719) 473-9595
(719) 227-0669
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01280791
—
CO
05
—
1013250240
—
CO
05
—
67174787
—
CO
05
—
9000173749
—
CO
05
—
93008716
—
CO
05
—
97656372
—
CO
Enumeration date
10/30/2019
Last updated
04/16/2025
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