| Vista Optical | |
|
102 W Octagon St, Bldg 77b, Cannon Afb, NM 88103-5207 | |
| (575) 904-1001 | |
| (575) 784-9722 |
| Full Name | Vista Optical |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 102 W Octagon St, Cannon Afb, New Mexico |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295188050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| 156FX1800X | Technician/technologist - Optician | (* (Not Available)) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Vista Optical 2435 Commerce Ave, Bldg 2200, Duluth, GA 30096-4980 Ph: (770) 822-3600 | Vista Optical 102 W Octagon St, Bldg 77b, Cannon Afb, NM 88103-5207 Ph: (575) 904-1001 |
Dr. Nicholas E Bem, OD Optometrist Medicare: Medicare Enrolled Practice Location: 27th Special Operations Medical Group, 224 W D.l. Ingram Avenue, Bldg. 1408, Cannon Afb, NM 88103 Phone: 575-904-3881 | |
Jason P Nolz, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 208 W Dl Ingram Ave, Cannon Afb, NM 88103 Phone: 575-784-6608 |