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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

NPI Number 1568550002
LBN Legal business name NEW MEXICO EYE CLINIC LL
Authorized official DONALD RODGERS - (M.D. -OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/10/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers
NM License # 258
NM License # 76-254
NM Medicaid 0000P0425
NM Medicaid 23200
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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