Organization
HERO VISION OF WEST ALBUQUERQUE
Active
Other names
Adventure Dental and Vision
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN URBANOZO (CREDENTIALING MANAGER)
(719) 576-1850
Entity
Organization
Contact information
Practice address
4208 CENTRAL AVE SW STE G, ALBUQUERQUE, NM 87105-1695
(719) 576-1850
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 576-1850
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT602
STATE LICENSE
NM
Enumeration date
01/20/2020
Last updated
02/10/2020
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