| |
85 W Highway 22, Santo Domingo, NM 87052-0340 | |
(505) 465-3060 | |
(505) 465-1191 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 85 W Highway 22, Santo Domingo, New Mexico |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467739615 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 559, Santo Domingo Pueblo, NM 87052-0559 Ph: (505) 465-3060 | 85 W Highway 22, Santo Domingo, NM 87052-0340 Ph: (505) 465-3060 |
Alexandra E Gada, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 85 West Highway 22, Santo Domingo, NM 87052 Phone: 505-465-3060 |