NPI 1003590886 · live from the CMS NPI Registry
Tayde Analy Contreras, OD
Optometrist in Gallup, NM. National Provider Identifier 1003590886, active.
NPI record
| NPI | 1003590886 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 516 E Nizhoni Blvd, Gallup, NM 87301 |
| Practice phone | 505-722-1000 |
| Mailing address | 4509 Waits Ave, Fort Worth, TX 76133 |
| Enumerated | June 13, 2023 |
| Last updated | June 13, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 13405450-9934 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.