Organization
VISIONWEST, INC.
Active
Other names
Dwight Thibodeaux
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT THIBODEAUX DO (OPTOMETRIST / OWNER)
(505) 984-8989
Entity
Organization
Contact information
Practice address
1610 N RIVERSIDE DR, ESPANOLA, NM 87532-8063
(505) 747-0433
Mailing address
499 CAMINO PINONES, SANTA FE, NM 87505-7523
(505) 984-8989
(505) 992-1069
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NM300
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962516039
—
NM
Enumeration date
06/26/2012
Last updated
10/25/2012
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