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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