MEDICARE: SEACAT OPTOMETRY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	NM464	NM

General Provider Information

NPI Number	:	1316198377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEACAT OPTOMETRY INC

Provider Business Mailing Address
First Line	:	2448 MISSOURI AVE
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-5109
Country	:	US
Telephone Number	:	575-521-1050
Fax Number	:	575-532-5070

Provider Business Practice Location Address
First Line	:	2448 MISSOURI AVE
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-5109
Country	:	US
Telephone Number	:	575-521-1050
Fax Number	:	575-532-5070

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN MARK SEACAT
Credential	:	O.D.
Telephone Number	:	575-521-1050

Provider Enumeration Date	:	10/08/2008
Last Update Date	:	09/27/2012

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