Organization
ALBUQUERQUE VISION CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARLYN A GANSEL ANG O.D. (MANAGING PARTNER)
(505) 332-2020
Entity
Organization
Contact information
Practice address
5343 WYOMING BLVD NE, SUITE 2, ALBUQUERQUE, NM 87109-3199
(505) 332-2020
(505) 856-7820
Mailing address
5343 WYOMING BLVD NE, SUITE 2, ALBUQUERQUE, NM 87109-3199
(505) 332-2020
(505) 856-7820
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP2-299
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346213154
NPI PROVIDER NUMBER
NM
01
—
1467425769
NPI PROVIDER NUMBER
NM
01
—
1578538872
NPI PROVIDER NUMBER
NM
01
—
1619942398
NPI PROVIDER NUMBER
NM
Enumeration date
01/02/2007
Last updated
10/03/2012
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