Eye Surgery Center Optical

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

EYE SURGERY CENTER OPTICAL

Practice address

8402 Clay St
Ste.4
Westminster, CO 80031-3847

Phone

(303) 426-8812

Fax

(303) 657-5597

NPI assigned

Feb 13, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. William G Self Jr., M.D

Title

Owner

Phone

(303) 426-8812

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1184766438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 CLAY ST",
            "address_2": "STE.4",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800313847",
            "telephone_number": "303-426-8812",
            "fax_number": "303-657-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 CLAY ST",
            "address_2": "STE.4",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800313847",
            "telephone_number": "303-426-8812",
            "fax_number": "303-657-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SURGERY CENTER OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SELF",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-426-8812",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CO",
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CO",
            "license": "20828",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eyesight LLC
• Rosemary A Eyeson, PHARMD
• Haleigh Fabac, RN
• Carissa Fain, SLP-CF
• Natalie Melka Fairbank

• Customized Equipment (DME) in Westminster, CO
• Providers in Westminster, CO by specialty
• Customized Equipment (DME) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.