Individual
DR. TERRY TYRONE MARQUARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
903 NEW YORK AVE, ALAMOGORDO, NM 88310-6919
(575) 437-7783
(575) 439-0615
Mailing address
903 NEW YORK AVE, ALAMOGORDO, NM 88310-6919
(575) 437-7783
(575) 439-0615
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
05843TG
TX
152W00000X
Optometrist
Primary
233
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000P6299
—
NM
01
—
540004536
RR MEDICARE
NM
01
—
NM00P012
BLUE CROSS BLUE SHIELD
NM
Enumeration date
08/01/2006
Last updated
05/11/2011
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