Provider Demographics
NPI:1477749661
Name:EL PASO EYES LLC
Entity Type:Organization
Organization Name:EL PASO EYES LLC
Other - Org Name:MESA EYECARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALOMIA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:915-600-5553
Mailing Address - Street 1:5869 OSCAR PEREZ
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-4217
Mailing Address - Country:US
Mailing Address - Phone:915-600-5553
Mailing Address - Fax:
Practice Address - Street 1:7831 PASEO DEL NORTE BLVD STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-8001
Practice Address - Country:US
Practice Address - Phone:915-600-5553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6358T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX216473301Medicaid
TXV10217Medicare UPIN
NMNMA100632Medicare PIN
TXTXB100760Medicare PIN