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GALLUP VISION SOURCE
NPI 1912142241
Optometrist in Gallup, NM

Active since December 16, 2008
124 W COAL AVE, GALLUP, NM 87301(505) 722-2020(505) 863-2204 Get Directions Write a Review

NPPES record last updated: December 16, 2008. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Gallup Vision Source NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GALLUP VISION SOURCE (NPI 1912142241) is a healthcare organization registered as an optometrist in Gallup, New Mexico and active in the NPI registry since December 2008. The organization lists Michael G Blake, Optometrist, as its authorized official.

NPPES Registry Identity

NPI1912142241
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameMICHAEL G BLAKE AND ASSOCIATES INC.
Location Address124 W COAL AVEGallup, NM 87301-6206
Mailing Address124 West Coal AveGallup, NM 87301 · (505) 722-2020 · Fax (505) 863-2204
Phone(505) 722-2020
Fax(505) 863-2204
Organization SubpartNo
Authorized OfficialMichael G BlakeOptometrist · (505) 722-2020
Enumeration DateDecember 16, 2008
✔ NPI 1912142241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
124 W COAL AVE, Gallup, NM 87301
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Other Names 1

Other NameGallup Vision Source

Other Identifiers 2

Medicare UPINT74910NM
OtherNM00O520NM · Blue Cross Blue Shield Nm

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL G BLAKE O.D.
Optometrist
124 W COAL AVE
GALLUP, NM 87301
McKinley County (505) 722-2020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael G Blake And Associates Inc.'s NPI number?

The NPI number for Michael G Blake And Associates Inc. is 1912142241. It was assigned to this organization in the NPPES registry on December 16, 2008. The provider is also known as Gallup Vision Source.

Where is Michael G Blake And Associates Inc. located?

Michael G Blake And Associates Inc. is located at 124 W Coal Ave, Gallup, NM 87301. The listed phone number is (505) 722-2020.

What is Michael G Blake And Associates Inc.'s specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

When was this NPI record last updated?

The NPPES record for Michael G Blake And Associates Inc. was last updated on December 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.