Organization Active NPI

Eye Deal Vision P.C.

  • Optometrist
  • Los Lunas, NM
National Provider Identifier
1346362845
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1551 Issued in NM
Legal business name
EYE DEAL VISION P.C.
Practice address
511A Highway 314 SW
Los Lunas, NM 87031-9600
Phone
(505) 565-3937
Fax
(505) 565-3900
NPI assigned
Apr 4, 2007
Last updated
Dec 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Authorized official

Name
Mrs. Mellisa R Flowers
Title
Office Manager
Phone
(505) 565-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1551 NM Primary

Addresses

Primary practice location

511A Highway 314 SW
Los Lunas, NM 87031-9600

Mailing address

511A Highway 314 SW
Los Lunas, NM 87031-9600
Phone (505) 565-3937

Other identifiers 1

IdentifierTypeStateIssuer
17973864MedicaidNM

National Provider Directory

National Provider Directory

Locations

511A Highway 314 SW
Los Lunas, NM 87031
Phone (505) 565-3937

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1346362845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511A HIGHWAY 314 SW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870319600",
            "telephone_number": "505-565-3937",
            "fax_number": "505-565-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511A HIGHWAY 314 SW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870319600",
            "telephone_number": "505-565-3937",
            "fax_number": "505-565-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE DEAL VISION P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "FLOWERS",
        "authorized_official_first_name": "MELLISA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-565-3937",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "1551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17973864",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.