Visionwest, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

NM300 Issued in NM

Legal business name

VISIONWEST, INC.

Practice address

1610 N Riverside Dr
Espanola, NM 87532-8063

Phone

(505) 747-0433

NPI assigned

Jun 26, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Dwight Thibodeaux, DO

Title

Optometrist / Owner

Phone

(505) 984-8989

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dwight Thibodeaux Doing business as

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1598029308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 CAMINO PINONES",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057523",
            "telephone_number": "505-984-8989",
            "fax_number": "505-992-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 N RIVERSIDE DR",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875328063",
            "telephone_number": "505-747-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONWEST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "THIBODEAUX",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "OPTOMETRIST / OWNER",
        "authorized_official_telephone_number": "505-984-8989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NM",
            "license": "NM300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962516039",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dwight Thibodeaux",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Vigil
• Veronica L Vigil, LMT
• Zachary Vigil
• Laurie L Vigne, RN, CDE
• Alexander Thomas Vining, PA-C
• Michael D Wagner, MD
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Valerie Lynn Wall, FNP-C

• Optometrist in Espanola, NM
• Providers in Espanola, NM by specialty
• Optometrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.