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General NPI Number Information
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NPI Number | 1457214496
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Entity Type | Organization
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Legal Business Name | FM OPTOMETRY PLLC
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Dates
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Enumeration Date | 12/06/2025
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 750 23RD AVE E
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City | WEST FARGO
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State | ND
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Zip | 58078-7804
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Country | US
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Telephone | 701-281-2237
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Fax | 701-281-2236
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Provider Business Mailing Address
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Address Line | 750 23RD AVE E
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City | WEST FARGO
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State | ND
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Zip | 58078-7804
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Country | US
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Telephone | 701-281-2237
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Fax | 701-281-2236
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | ANDREW VIET PHAM
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Credential | OD
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Telephone | 320-766-7778
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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 |
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License Number State |
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