Provider Demographics
NPI:1730369786
Name:MOORE, SARAH M (OD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:MOORE
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 1:738 PEORIA ST STE H
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8202
Mailing Address - Country:US
Mailing Address - Phone:720-844-2020
Mailing Address - Fax:
Practice Address - Street 1:738 PEORIA ST STE H
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8202
Practice Address - Country:US
Practice Address - Phone:720-844-2020
Practice Address - Fax:303-927-7711
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2616152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91358833Medicaid