| NPI | 1114354719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD VICTOR HERNANDEZ Owner/President 575-522-9051 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NM 98-290) |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2016-03-21 |