Healthcare Provider Details

I. General information

NPI: 1275735060
Provider Name (Legal Business Name): EYES TO YOU, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 HIGHWAY 491
GALLUP NM
87301-5382
US

IV. Provider business mailing address

1109 HIGHWAY 491
GALLUP NM
87301-5382
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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