| NPI | 1073090650 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2018-07-26 |
| Last Updated | 2021-01-10 |
| Authorized Official | Brandi Mcgraw President/OD Phone: 5053392015 |
| Mailing Address | 816 Boardman Dr Gallup, NM 87301-4711 United States Phone: (505) 339-2015 | Fax: (505) 492-0904 📍 View Map |
| Primary Practice Address | 816 Boardman Dr Gallup, NM 87301-4711 United States Phone: (505) 339-2015 | Fax: (505) 492-0904 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | NM | 16438311 | - |
| MEDICAID | AZ | 525331 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 152W00000X – Optometrist | - | - |
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →
About NPI 1073090650
Gallup Eye Group Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1073090650. The primary specialty listed is Optometrist. The organization is located in Gallup, NM. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2018-07-26. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1073090650?
NPI 1073090650 belongs to Gallup Eye Group Llc, a Optometrist in Gallup, NM. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1073090650 active?
The current status of NPI 1073090650 in the NPPES registry is Active. The record was last updated on 2021-01-10.
What specialty is NPI 1073090650?
NPI 1073090650 is classified under the taxonomy Optometrist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1073090650?
You can verify NPI 1073090650 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1073090650?
The primary practice address on file for NPI 1073090650 is 816 Boardman Dr, Gallup, NM 87301-4711. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1073090650 issued?
NPI 1073090650 was first issued (enumerated) on 2018-07-26. The NPPES record was last updated on 2021-01-10.
Practice Location Map
Gallup Eye Group Llc is located at 816 Boardman Dr, Gallup, NM. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Gallup Eye Group Llc. All records sourced from the CMS NPPES registry.