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General NPI Number Information
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NPI Number | 1447242250
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Entity Type | Organization
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Legal Business Name | PRECISION EYE CENTER
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 08/24/2009
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Provider Practice Location Address
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Address Line | 8000 PASEO DEL NORTE NE BUILDING E
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-2983
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Country | US
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Telephone | 505-291-1711
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Fax | 505-298-0934
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Provider Business Mailing Address
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Address Line | 8000 PASEO DEL NORTE NE BUILDING E
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-2983
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Country | US
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Telephone | 505-291-1711
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Fax | 505-298-0934
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT LAVOIE
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Credential | O.D.
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Telephone | 505-291-1711
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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 | OP2499
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License Number State | NM
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