Organization
CHARLES W. BROOKS, O.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES W. BROOKS O.D. (PRESIDENT)
(575) 359-1252
Entity
Organization
Contact information
Practice address
201 S ABILENE AVE, PORTALES, NM 88130-6207
(575) 359-1252
(575) 359-2601
Mailing address
201 S ABILENE AVE, PORTALES, NM 88130-6207
(575) 359-1252
(575) 359-2601
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2292
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM00P023
BCBS NEW MEXICO
NM
05
—
P0565
—
NM
Enumeration date
02/21/2008
Last updated
02/21/2008
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