Healthcare Provider Details

I. General information

NPI: 1639339674
Provider Name (Legal Business Name): ACCUTECH FAMILY EYE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N SOLANO DR STE 3
LAS CRUCES NM
88001-2900
US

IV. Provider business mailing address

301 N SOLANO DR STE 3
LAS CRUCES NM
88001-2900
US

V. Phone/Fax

Practice location:
  • Phone: 575-541-1075
  • Fax: 575-541-5997
Mailing address:
  • Phone: 575-541-1075
  • Fax: 575-541-5997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberNM313
License Number StateNM

VIII. Authorized Official

Name: JUAN LUCERO
Title or Position: OWNER
Credential: OD
Phone: 575-541-1075