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Individual

DR. DEIDRA MARIE CASAUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
160 S CAMINO DEL PUEBLO, STE E, BERNALILLO, NM 87004-6173
(505) 771-3937
(505) 771-1282
Mailing address
3566 WHITE HORSE DR SE, RIO RANCHO, NM 87124-3676
(505) 771-3937
(505) 771-1282

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
408
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201001544
PRESBYTERIAN HEALTH
NM
01
850429787
LOVELACE MOLINA
NM
01
NM01P393
BLUE CROSS BLUE SHIELD
NM
05
P5028
NM
Enumeration date
08/14/2006
Last updated
12/20/2016
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