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General NPI Number Information
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NPI Number | 1912182932
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Entity Type | Organization
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Legal Business Name | ALBUQUERQUE ASSOCIATES OF OPTOMETRY
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 112 HERMOSA DR SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-2610
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Country | US
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Telephone | 505-265-3443
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Fax | 505-265-7006
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Provider Business Mailing Address
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Address Line | 112 HERMOSA DR SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-2610
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Country | US
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Telephone | 505-265-3443
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Fax | 505-265-7006
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Authorized Official
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Title or Position | CO-OWNER
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Name | KAZUKO K PURO
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Credential | O.D.
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Telephone | 505-265-3443
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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 | 2326
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License Number State | NM
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