Provider Demographics
NPI:1538248026
Name:ENGLISH, MICHAEL LEROY (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEROY
Last Name:ENGLISH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4924 CHAGAR CT
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-5464
Mailing Address - Country:US
Mailing Address - Phone:505-525-3452
Mailing Address - Fax:
Practice Address - Street 1:2001 E LOHMAN AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-3167
Practice Address - Country:US
Practice Address - Phone:505-525-3937
Practice Address - Fax:505-524-0196
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOP 2222152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMT74955Medicare UPIN