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General NPI Number Information
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NPI Number | 1114354719
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Entity Type | Organization
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Legal Business Name | FRAMED, LLC
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Dates
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Enumeration Date | 09/27/2013
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Last Update Date | 03/21/2016
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Provider Practice Location Address
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Address Line | 2810 N TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-8230
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Country | US
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Telephone | 575-522-9051
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Fax |
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Provider Business Mailing Address
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Address Line | 2810 N TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-8230
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Country | US
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Telephone | 575-522-9051
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. EDWARD VICTOR HERNANDEZ
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Credential | M.D.
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Telephone | 575-522-9051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 98-290
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License Number State | NM
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