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
Fax: (575) 439-0615
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801803044 NPPES
New Mexico MEDICAID 000P6299
New Mexico Other NM00P012
New Mexico Other 540004536

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