Marquardt, Terry Tyrone
Marquardt, Terry Tyrone is an sole proprietor health care provider with primary practice located at 903 New York Ave , Alamogordo NM 88310-6919. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Marquardt, Terry Tyrone can be contacted via phone (575) 437-7783.Contact Information
Primary practice address
903 New York Ave
Alamogordo NM 88310-6919
Phone: (575) 437-7783
Fax: (575) 439-0615
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 233 | New Mexico |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 05843TG | Texas |
Profile Details
| NPI number | 1801803044 |
|---|---|
| LBN Legal business name | Marquardt, Terry Tyrone |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 1st, 2006 |
| Last updated | May 11th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801803044 | NPPES |
| New Mexico | MEDICAID | 000P6299 | |
| New Mexico | Other | NM00P012 | |
| New Mexico | Other | 540004536 |
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