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General NPI Number Information
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NPI Number | 1609913482
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Entity Type | Organization
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Legal Business Name | EYE ASSOCIATES OF NEW MEXICO, LTD.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 248 MILLS AVE
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City | LAS VEGAS
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State | NM
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Zip | 87701-4125
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Country | US
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Telephone | 505-426-8866
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Fax | 505-426-8601
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Provider Business Mailing Address
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Address Line | 8801 HORIZON BLVD NE SUITE 360
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-1533
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Country | US
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Telephone | 505-246-2622
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Fax | 505-213-0103
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | CAROLE JEAN WRIGHT
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Credential | CAO
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Telephone | 505-768-1335
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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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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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