Provider Demographics
NPI:1902518087
Name:EYE ENVY VISION INC
Entity Type:Organization
Organization Name:EYE ENVY VISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:720-530-5390
Mailing Address - Street 1:PO BOX 390696
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-1696
Mailing Address - Country:US
Mailing Address - Phone:720-530-5390
Mailing Address - Fax:
Practice Address - Street 1:700 S BUCKLEY RD APT K
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-3253
Practice Address - Country:US
Practice Address - Phone:720-730-5390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty