Healthcare Provider Details

I. General information

NPI: 1861427841
Provider Name (Legal Business Name): CARA ANN MORRIS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 HARPER DRIVE NE
ALBUQUERQUE NM
87109
US

IV. Provider business mailing address

8801 HORIZON BLVD NE SUITE 360
ALBUQUERQUE NM
87113-1533
US

V. Phone/Fax

Practice location:
  • Phone: 505-888-5757
  • Fax: 505-889-3589
Mailing address:
  • Phone: 505-828-4923
  • Fax: 505-213-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number560
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: