MEDICARE: DR. CARL ERNEST ZIMMERMAN O.D.

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	152WC0802X	Corneal and Contact Management Optometrist	1944-TG	TX

General Provider Information

NPI Number	:	1942386081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL ERNEST ZIMMERMAN O.D.

Provider Business Mailing Address
First Line	:	700 S TELSHOR BLVD
Second Line	:	SUITE #1534
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4669
Country	:	US
Telephone Number	:	575-522-8334
Fax Number	:	575-522-1065

Provider Business Practice Location Address
First Line	:	700 S TELSHOR BLVD
Second Line	:	SUITE #1534
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4669
Country	:	US
Telephone Number	:	575-522-8334
Fax Number	:	575-522-1065

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	10/17/2011

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