NPIMap

Organization Active NPI

Fashion Optical and Sunwear

  • Eyewear Supplier
  • Albuquerque, NM
National Provider Identifier
1174743280
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
03074110006 Issued in NM
Legal business name
FASHION OPTICAL AND SUNWEAR
Practice address
7415 Menaul Blvd NE
Albuquerque, NM 87110
Phone
(505) 888-3991
Fax
(505) 830-2974
NPI assigned
Apr 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Annette M Baca
Title
Manager
Phone
(505) 888-3991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 03074110006 NM Primary

Addresses

Primary practice location

7415 Menaul Blvd NE
Albuquerque, NM 87110

Mailing address

7415 Menaul Blvd NE
Albuquerque, NM 87110
Phone (505) 888-3991

Other identifiers 1

IdentifierTypeStateIssuer
21503371MedicaidNM

National Provider Directory

National Provider Directory

Locations

7415 Menaul Blvd NE
Albuquerque, NM 87110
Phone (505) 888-3991

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174743280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7415 MENAUL BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-888-3991",
            "fax_number": "505-830-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7415 MENAUL BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-888-3991",
            "fax_number": "505-830-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FASHION OPTICAL AND SUNWEAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BACA",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "505-888-3991",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NM",
            "license": "03074110006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21503371",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • 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.