Charles W. Brooks, O.D., P.C.
Organization Active NPI Optometrist · Portales, NM
NPI 1508035817 · NPPES record last updated Feb 21, 2008
Key facts
- NPI
- 1508035817
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 2292 (NM)
- Legal business name
- CHARLES W. BROOKS, O.D., P.C.
- Practice address
- 201 S Abilene Ave
Portales, NM 88130-6207 - Phone
- (575) 359-1252
- Fax
- (575) 359-2601
- NPI assigned
- Feb 21, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Charles W. Brooks, O.D.
- Title
- President
- Phone
- (575) 359-1252
National Provider Directory
Locations
201 S Abilene Ave
Portales, NM 88130
Phone (505) 359-1252
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 2292 | NM | Yes |
Addresses
Primary practice location
201 S Abilene Ave
Portales, NM 88130-6207
Mailing address
201 S Abilene Ave
Portales, NM 88130-6207
Phone (575) 359-1252
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM00P023 | Other | NM | BCBS NEW MEXICO |
| P0565 | Medicaid | NM |
Other providers in Portales, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2008. 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.