Basic Information
| Provider Information | |||||||||
| NPI: | 1669969945 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | QUALITY EYE CARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4918 N BREANNA ST | ||||||||
| Address2: | |||||||||
| City: | HOBBS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 882429811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8064705400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3305 N GRIMES ST | ||||||||
| Address2: | |||||||||
| City: | HOBBS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 882401219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5753920120 | ||||||||
| FaxNumber: | 5753920160 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2018 | ||||||||
| LastUpdateDate: | 04/22/2018 | ||||||||
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| AuthorizedOfficialLastName: | GOOD | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | JOHN | ||||||||
| AuthorizedOfficialTitleorPosition: | MEMBER/OPHTHALMOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 8064705400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.