David Vise OD, LLC
Organization Active NPI Medical Specialty Clinic/Center · Santa Fe, NM
NPI 1346685658 · NPPES record last updated Aug 13, 2013
Key facts
- NPI
- 1346685658
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medical Specialty Clinic/Center 261QM2500X
- License
- 411 (NM)
- Legal business name
- DAVID VISE OD, LLC
- Practice address
- 3530 Zafarano Dr
Suite C1
Santa Fe, NM 87507-2617 - Phone
- (505) 473-5100
- Fax
- (505) 473-5104
- NPI assigned
- May 1, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. David Richard Vise, O.D.
- Title
- Optometrist
- Phone
- (505) 473-5100
Practitioners 2
National Provider Directory
Locations
3530 Zafarano Dr
Ste C1
Santa Fe, NM 87507
Phone (505) 438-3431
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | 411 | NM | Yes |
Addresses
Primary practice location
3530 Zafarano Dr
Suite C1
Santa Fe, NM 87507-2617
Mailing address
3530 Zafarano Dr
Suite C1
Santa Fe, NM 87507-2617
Phone (505) 473-5100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J9416 | Medicaid | NM |
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All providers in Santa Fe, NM · Medical Specialty Clinic/Center in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.