Healthcare Provider Details

I. General information

NPI: 1730293119
Provider Name (Legal Business Name): KRISTA ANNETTE HEIDAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTA ANNETTE HUNTER M.D.

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 MULBERRY ST NE
ALBUQUERQUE NM
87106-4739
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-243-9739
  • Fax: 505-842-0650
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD00046976
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License NumberMD2022-1530
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: