MEDICARE: DR. DEBORAH LOUISE MOY O.D.

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	152W00000X	Optometrist	NMPO2330	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710098041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH LOUISE MOY O.D.

Provider Business Mailing Address
First Line	:	5341 WYOMING BLVD NE
Second Line	:	SUITE D
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-3164
Country	:	US
Telephone Number	:	505-821-8333
Fax Number	:	505-821-8335

Provider Business Practice Location Address
First Line	:	5341 WYOMING BLVD NE
Second Line	:	SUITE D
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-3164
Country	:	US
Telephone Number	:	505-821-8333
Fax Number	:	505-821-8335

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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