1689528416 NPI number — TOTAL VISION EYE CARE GROUP LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689528416 NPI number — TOTAL VISION EYE CARE GROUP LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL VISION EYE CARE GROUP LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689528416
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 200426
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75320-0426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-524-1001
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4103 BOARDWALK DR UNIT 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT COLLINS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80525-5933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-377-2020
Provider Business Practice Location Address Fax Number:
303-377-2022
Provider Enumeration Date:
02/26/2026

Additional Information

Authorized Official

Authorized Official Last Name:
ABBATE
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
720-524-1001

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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