Provider Demographics
NPI:1316198377
Name:SEACAT OPTOMETRY INC
Entity Type:Organization
Organization Name:SEACAT OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:SEACAT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:575-521-1050
Mailing Address - Street 1:2448 MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-5109
Mailing Address - Country:US
Mailing Address - Phone:575-521-1050
Mailing Address - Fax:575-532-5070
Practice Address - Street 1:2448 MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-5109
Practice Address - Country:US
Practice Address - Phone:575-521-1050
Practice Address - Fax:575-532-5070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNM464152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNMA102285Medicare PIN