St Martin de Porres Eye Clinic PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

2002-0264 Issued in NM

Legal business name

ST MARTIN DE PORRES EYE CLINIC PC

Practice address

1208 South Columbus Rd
Deming, NM 88030

Phone

(505) 544-0048

Fax

(505) 544-0165

NPI assigned

Dec 1, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas M Boyle, MD

Title

Owner

Phone

(505) 544-0048

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043388671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 SOUTH COLUMBUS RD",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "88030",
            "telephone_number": "505-544-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 SOUTH COLUMBUS RD",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "88030",
            "telephone_number": "505-544-0048",
            "fax_number": "505-544-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARTIN DE PORRES EYE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-544-0048",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NM",
            "license": "2002-0264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Deming, NM
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• Ophthalmology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.