Provider Demographics
NPI:1508741695
Name:GORR, AMANDA CAMERON (OD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:CAMERON
Last Name:GORR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8801 HORIZON BLVD NE STE 360
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1563
Mailing Address - Country:US
Mailing Address - Phone:505-246-2622
Mailing Address - Fax:505-715-5334
Practice Address - Street 1:5200 EUBANK BLVD NE STE A4
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1760
Practice Address - Country:US
Practice Address - Phone:505-298-4419
Practice Address - Fax:505-298-0878
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOPT-2025-0015152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist