Organization
CLASSIC EYEWEAR, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND P HERRERA O.D. (OWNER)
(505) 326-2020
Entity
Organization
Contact information
Practice address
113 W BROADWAY, FARMINGTON, NM 87401-6419
(505) 326-2020
(505) 327-5530
Mailing address
113 W BROADWAY, FARMINGTON, NM 87401-6419
(505) 326-2020
(505) 327-5530
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
437
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P2124
—
NM
Enumeration date
05/15/2008
Last updated
09/25/2013
Update your record
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