Provider Demographics
NPI:1548608870
Name:BRIGGS, CHARLES RAND (OD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:RAND
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7011 RIO GRANDE BLVD NW
Mailing Address - Street 2:
Mailing Address - City:LOS RANCHOS
Mailing Address - State:NM
Mailing Address - Zip Code:87107-6423
Mailing Address - Country:US
Mailing Address - Phone:505-730-9170
Mailing Address - Fax:505-344-2529
Practice Address - Street 1:7011 RIO GRANDE BLVD NW
Practice Address - Street 2:
Practice Address - City:LOS RANCHOS
Practice Address - State:NM
Practice Address - Zip Code:87107-6423
Practice Address - Country:US
Practice Address - Phone:505-730-9170
Practice Address - Fax:505-344-2529
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-09
Last Update Date:2013-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM206152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist