Provider Demographics
NPI:1588951990
Name:CROSS, ERIC (OD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:CROSS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8499 E LOWRY BLVD APT 310
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7266
Mailing Address - Country:US
Mailing Address - Phone:219-229-4899
Mailing Address - Fax:
Practice Address - Street 1:910 16TH ST STE 524
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-2921
Practice Address - Country:US
Practice Address - Phone:303-534-8811
Practice Address - Fax:303-825-0109
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002042152W00000X
IN18003694A152W00000X
CO0003046152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist