Individual
GERALD L VALDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
210 W COAL AVE, GALLUP, NM 87301-6306
(505) 863-4101
(505) 863-4101
Mailing address
210 W COAL AVE, GALLUP, NM 87301-6306
(505) 863-4101
(505) 863-4101
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
56421842
—
NM
Enumeration date
02/09/2010
Last updated
02/09/2010
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