Hv Pueblo South LLC

NPI #1033713599 in Pueblo, Colorado

Provider Information

NPI Number: 1033713599
Entity Type: Organization
Organization Name: Hv Pueblo South LLC
Subpart: Yes (part of a larger organization)
Parent Organization: HV PUEBLO SOUTH
Primary Specialty: Optometrist
Enumeration Date: Nov 25, 2020
Last Updated: Nov 25, 2020

Practice Location

Address: 1725 S PUEBLO BLVD
City: Pueblo
State: Colorado
ZIP Code: 81005-2103
Phone: (719) 281-2633

Authorized Official

Name: SHAUN URBANOZO
Title: CREDENTIALING MANAGER
Phone: (719) 323-2362

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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