Organization
ADVANCED OPTOMETRIC CONCEPTS, PC
Active
Other names
THE VISION STORE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEIDRA M CASAUS O.D. (PRESIDENT)
(505) 771-3937
Entity
Organization
Contact information
Practice address
140 E HWY 550, SUITE E, BERNALILLO, NM 87004-5943
(505) 771-3937
(505) 771-1282
Mailing address
3566 WHITE HORSE DR SE, RIO RANCHO, NM 87124-3676
(505) 771-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
63225778
—
NM
05
—
P5028
—
NM
Enumeration date
04/07/2008
Last updated
04/30/2010
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