Provider Demographics
NPI:1548411135
Name:PACHECO, SHARON SUNNY (OD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:SUNNY
Last Name:PACHECO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5504 MENAUL BLVD NE
Mailing Address - Street 2:STE A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3184
Mailing Address - Country:US
Mailing Address - Phone:505-888-1152
Mailing Address - Fax:505-888-8942
Practice Address - Street 1:5504 MENAUL BLVD NE STE AB
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110
Practice Address - Country:US
Practice Address - Phone:505-888-1152
Practice Address - Fax:505-888-8942
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM593152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist