Provider Demographics
NPI:1841681269
Name:NEW MEXICO LASER EYE CENTER, LLC
Entity type:Organization
Organization Name:NEW MEXICO LASER EYE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:T
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-467-0459
Mailing Address - Street 1:PO BOX 50720
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-0720
Mailing Address - Country:US
Mailing Address - Phone:806-467-0459
Mailing Address - Fax:806-355-1284
Practice Address - Street 1:205 EAST LLANO ESTACADO BLVD.
Practice Address - Street 2:SUITE A
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101
Practice Address - Country:US
Practice Address - Phone:806-353-0125
Practice Address - Fax:806-355-0834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty