Provider Demographics
NPI:1821177155
Name:LAZARO, RICHARD W (MD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:W
Last Name:LAZARO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6816 LAZO DEL NORTE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-2598
Mailing Address - Country:US
Mailing Address - Phone:505-522-7676
Mailing Address - Fax:505-522-8121
Practice Address - Street 1:1505 S DON ROSER DR STE A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4596
Practice Address - Country:US
Practice Address - Phone:575-522-7676
Practice Address - Fax:575-522-8121
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2022-11-29
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Provider Licenses
StateLicense IDTaxonomies
NM83236207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM32540Medicaid
A82921Medicare UPIN