Provider Demographics
NPI:1093398570
Name:RUGAMA, SANDRA MARIA (OD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:MARIA
Last Name:RUGAMA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 ALPINE DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-4015
Mailing Address - Country:US
Mailing Address - Phone:956-483-5983
Mailing Address - Fax:303-666-6520
Practice Address - Street 1:615 MAIN ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1894
Practice Address - Country:US
Practice Address - Phone:303-666-6320
Practice Address - Fax:303-666-6520
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-03
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X152W00000X
COOPT.0003768152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist