Organization
MED PARK OPTICAL SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL STEVENSON ABOC (OWNER)
(575) 524-2666
Entity
Organization
Contact information
Practice address
1300 EL PASEO, STE F, LAS CRUCES, NM 88001-6039
(575) 524-2666
(575) 524-4328
Mailing address
1300 EL PASEO, STE F, LAS CRUCES, NM 88001-6039
(575) 524-2666
(575) 524-4328
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111906
EYE MED VISION CARE
—
Enumeration date
09/13/2006
Last updated
09/26/2008
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