Provider Demographics
NPI:1063064541
Name:PINCOCK, ZACCARY JOHN E (OD)
Entity type:Individual
Prefix:DR
First Name:ZACCARY
Middle Name:JOHN E
Last Name:PINCOCK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 N DAL PASO ST
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-3042
Mailing Address - Country:US
Mailing Address - Phone:575-397-3611
Mailing Address - Fax:575-393-1544
Practice Address - Street 1:1811 N DAL PASO ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-3042
Practice Address - Country:US
Practice Address - Phone:575-397-3611
Practice Address - Fax:575-393-1544
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOPT714152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist