MEDICARE: MICHAEL D. CONTE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3120T	TX

General Provider Information

NPI Number	:	1851580351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL D. CONTE PC

Provider Business Mailing Address
First Line	:	6636 LAKE WORTH BLVD
Second Line	:	STE. 300
City	:	LAKE WORTH
State	:	TX
Zip	:	76135-3026
Country	:	US
Telephone Number	:	817-626-4441
Fax Number	:	817-237-3438

Provider Business Practice Location Address
First Line	:	6636 LAKE WORTH BLVD
Second Line	:	STE. 300
City	:	LAKE WORTH
State	:	TX
Zip	:	76135-3026
Country	:	US
Telephone Number	:	817-626-4441
Fax Number	:	817-625-7675

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL D CONTE
Credential	:	O.D.
Telephone Number	:	817-626-4441

Provider Enumeration Date	:	10/19/2007
Last Update Date	:	02/02/2012

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