Provider Demographics
NPI:1033318902
Name:CORDES, CHRISTOPHER CHARLES (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:CHARLES
Last Name:CORDES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 VASSAR DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2725
Mailing Address - Country:US
Mailing Address - Phone:505-248-4003
Mailing Address - Fax:505-248-7721
Practice Address - Street 1:801 VASSAR DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106
Practice Address - Country:US
Practice Address - Phone:505-248-4003
Practice Address - Fax:505-248-7721
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13279T152W00000X
CA13297152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM88282902Medicaid
NMH3451Medicaid