Organization
EYE CARE SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY PURO M.D. (OWNER)
(505) 753-7391
Entity
Organization
Contact information
Practice address
105 N CORONADO AVE, ESPANOLA, NM 87532-2741
(505) 753-7391
Mailing address
105 N CORONADO AVE, ESPANOLA, NM 87532-2741
(505) 753-7391
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
6164
NM
Other
Enumeration date
08/08/2006
Last updated
08/22/2020
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