Reynolds, Dean Stanton

Reynolds, Dean Stanton is an individual health care provider with primary practice located at 4025 Jackie Rd Se , Rio Rancho NM 87124-6610. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Reynolds, Dean Stanton can be contacted via phone (505) 892-8411.

Contact Information

Primary practice address
4025 Jackie Rd Se Rio Rancho NM 87124-6610
Fax: (505) 891-5497
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OP2264 New Mexico

Profile Details

NPI number 1043290851
LBN Legal business name Reynolds, Dean Stanton
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Jun 15th, 2024 - about 5 months 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 1043290851 NPPES
New Mexico Other NM01P037 BLUE CROSS BLUE SHEILD NM
New Mexico Other NM2264 BLUE CROSS BLUE SHEILD NM
New Mexico Other NMOP2264 BLUE CROSS BLUE SHEILD NM
New Mexico MEDICAID 152W00000X BLUE CROSS BLUE SHEILD NM

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