Doctor Name: | MR. RAY J MONTOYA |
NPI Number: | 1043534209 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LICENSED OPTICIAN |
License Number: | 164267 |
Business Practice Address: | 1908 N Prince St Clovis, NM - 881014857 |
Business Phone Number: | 5757697766 |
Business Fax Number: | 5757697015 |
Mailing Address: | 1908 N. Prince Street, CLOVIS |
State: | NM |
Postal Code: | 88101 |
Phone Number: | 5757697766 |
Fax Number: | 5757697015 |
NPI Enumeration Date: | 03/17/2010 |
NPI Last Update Date: | 03/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 164267 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |