Healthcare Provider Details

I. General information

NPI: 1043439003
Provider Name (Legal Business Name): EYES TO YOU, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S 2ND ST SUITE 6
GALLUP NM
87301-5862
US

IV. Provider business mailing address

PO BOX 2290
GALLUP NM
87305-2290
US

V. Phone/Fax

Practice location:
  • Phone: 505-722-7254
  • Fax: 505-863-4266
Mailing address:
  • Phone: 505-722-7254
  • Fax: 505-863-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number StateNM

VIII. Authorized Official

Name: MS. TANNI IRWIN
Title or Position: CO-OWNER
Credential:
Phone: 505-722-7254