Provider Demographics
NPI:1922566769
Name:V.A.C, LLC
Entity Type:Organization
Organization Name:V.A.C, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:O.D./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-899-3937
Mailing Address - Street 1:6321 RIVERSIDE PLAZA LN NW STE B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2641
Mailing Address - Country:US
Mailing Address - Phone:505-897-3937
Mailing Address - Fax:
Practice Address - Street 1:6321 RIVERSIDE PLAZA LN NW STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-2641
Practice Address - Country:US
Practice Address - Phone:505-897-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty