| The Vision Store | |
|
140 E Hwy 550, Suite E, Bernalillo, NM 87004-5943 | |
| (505) 771-3937 | |
| (505) 771-1282 |
| Full Name | The Vision Store |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 140 E Hwy 550, Bernalillo, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578736054 | NPI | - | NPPES |
| 63225778 | Medicaid | NM | |
| P5028 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Deidra M Casaus |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609889310 PECOS PAC ID: 9133295538 Enrollment ID: I20080909000504 |
| Provider Name | Robert Ryan Fontenot |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396324380 PECOS PAC ID: 4688079858 Enrollment ID: I20220331000801 |
| Mailing Address | Practice Location Address |
|---|---|
| The Vision Store 3566 White Horse Dr Se, Rio Rancho, NM 87124-3676 Ph: (505) 771-3937 | The Vision Store 140 E Hwy 550, Suite E, Bernalillo, NM 87004-5943 Ph: (505) 771-3937 |
Robert Ryan Fontenot, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 160 S Camino Del Pueblo, Bernalillo, NM 87004 Phone: 505-771-3937 | |
Edwin H. Robison Iii, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 460 Hwy 528, Bernalillo, NM 87004 Phone: 505-771-4883 Fax: 505-771-4885 | |
Dr. Deidra Marie Casaus, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 160 S Camino Del Pueblo, Ste E, Bernalillo, NM 87004 Phone: 505-771-3937 Fax: 505-771-1282 |