Individual
DR. BRANDI NICHOLE SMITH MCGRAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
816 BOARDMAN DR, GALLUP, NM 87301-4711
(505) 339-2015
(505) 492-0904
Mailing address
816 BOARDMAN DR, GALLUP, NM 87301-4711
(505) 339-2015
(505) 492-0904
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
605
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08778311
—
NM
05
—
525331
—
AZ
01
—
P00841382
MEDICARE RAILROAD CARRIER
NM
Enumeration date
02/09/2009
Last updated
01/10/2021
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