Organization
EYE ASSOCIATES OF NEW MEXICO LTD
Active
Other names
Eye Associates of New Mexico
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE R. BUTCHER (CREDENTIALING MANAGER)
(505) 828-4923
Entity
Organization
Contact information
Practice address
311 NIZHONI BLVD, GALLUP, NM 87301
(505) 722-2268
(505) 863-2874
Mailing address
8801 HORIZON BLVD NE, SUITE 360, ALBUQUERQUE, NM 87113-1533
(505) 246-2622
(505) 213-0103
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47951
—
NM
01
—
CH4370
RAILROAD MEDICARE (RRB)
NM
01
—
CN6728
RAILROAD MEDICARE (RRB)
NM
05
—
K5006
—
NM
Enumeration date
01/31/2007
Last updated
02/24/2014
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