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General NPI Number Information
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NPI Number | 1164825287
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Entity Type | Organization
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Legal Business Name | ALVAREZ REIGSTAD OPTOMETRY, P.C.
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Dates
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Enumeration Date | 10/03/2014
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Last Update Date | 10/03/2014
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Provider Practice Location Address
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Address Line | 500 EUBANK BLVD SE SUITE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-3338
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Country | US
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Telephone | 505-323-2555
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Fax | 505-323-0888
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Provider Business Mailing Address
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Address Line | 2109 GOLD AVE SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4005
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Country | US
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Telephone | 951-312-9596
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OPTOMETRIST
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Name | DR. LUISA RAHELL ALVAREZ
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Credential | OD
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Telephone | 951-312-9596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 585
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License Number State | NM
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