Healthcare Provider Details

I. General information

NPI: 1114354719
Provider Name (Legal Business Name): FRAMED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 03/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 N TELSHOR BLVD
LAS CRUCES NM
88011-8230
US

IV. Provider business mailing address

2810 N TELSHOR BLVD
LAS CRUCES NM
88011-8230
US

V. Phone/Fax

Practice location:
  • Phone: 575-522-9051
  • Fax:
Mailing address:
  • Phone: 575-522-9051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number98-290
License Number StateNM

VIII. Authorized Official

Name: DR. EDWARD VICTOR HERNANDEZ
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 575-522-9051