Provider Demographics
NPI:1578013827
Name:ASHLEY J PULIS OD LLC
Entity Type:Organization
Organization Name:ASHLEY J PULIS OD LLC
Other - Org Name:ACCENT ON VISION ALBUQUERQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PULIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:505-898-4884
Mailing Address - Street 1:9131 HIGH ASSETS WAY NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-5807
Mailing Address - Country:US
Mailing Address - Phone:505-898-4884
Mailing Address - Fax:
Practice Address - Street 1:9131 HIGH ASSETS WAY NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-5807
Practice Address - Country:US
Practice Address - Phone:505-898-4884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM635261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center