MEDICARE: ANDREW MCDONNELL BCO, BADO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1700X	Ocularist

General Provider Information

NPI Number	:	1629916804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW MCDONNELL BCO, BADO

Provider Business Mailing Address
First Line	:	7708 PICKARD AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-1562
Country	:	US
Telephone Number	:	505-280-7479
Fax Number	:

Provider Business Practice Location Address
First Line	:	7708 PICKARD AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-1562
Country	:	US
Telephone Number	:	505-280-7479
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ ANDREW MCDONNELL BCO, BADO” Practice Location

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