MEDICARE: CHRISTINA PELTROP

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	OPC6685	FL

General Provider Information

NPI Number	:	1780578260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA PELTROP

Provider Business Mailing Address
First Line	:	700 S TELSHOR BLVD STE 1536
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-8608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 S TELSHOR BLVD STE 1536
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-8608
Country	:	US
Telephone Number	:	575-522-8244
Fax Number	:

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

Provider Enumeration Date	:	06/07/2025
Last Update Date	:	09/08/2025

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Directions to “ CHRISTINA PELTROP ” Practice Location

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