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Contact Information

NEW MEXICO EYE CLINIC LL
1316 JACKIE RD SE STE 850
RIO RANCHO, NM87124-6606
 Phone: 505-891-0880
 Fax: 505-891-5415
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for NEW MEXICO EYE CLINIC LL · (Female)

NPI # 1568550002
Status Active
Credentials
Entity Individual
Enumeration date 10/10/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers
  • NM License # 258
  • NM License # 76-254
  • NM Medicaid 0000P0425
  • NM Medicaid 23200
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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