Healthcare Provider Details

I. General information

NPI: 1700995941
Provider Name (Legal Business Name): LOOKS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 E BOUTZ RD
LAS CRUCES NM
88005-3255
US

IV. Provider business mailing address

PO BOX 819
LAS CRUCES NM
88004-0819
US

V. Phone/Fax

Practice location:
  • Phone: 575-526-3314
  • Fax: 575-526-1061
Mailing address:
  • Phone: 575-526-3314
  • Fax: 575-526-1061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MONICA CARMONA
Title or Position: BILLER
Credential:
Phone: 575-526-3314