Provider Demographics
NPI:1659483774
Name:OLGUIN, ABRAN GILBERT (OD)
Entity Type:Individual
Prefix:DR
First Name:ABRAN
Middle Name:GILBERT
Last Name:OLGUIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6309 SUMMERWOOD RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-6107
Mailing Address - Country:US
Mailing Address - Phone:505-205-6656
Mailing Address - Fax:
Practice Address - Street 1:4101 MORRIS ST NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3605
Practice Address - Country:US
Practice Address - Phone:505-299-4426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM575152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist