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General NPI Number Information
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NPI Number | 1215043765
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Entity Type | Individual
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Provider Name | MARIO JOSEPH CONTALDI O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 7728 MID CITIES BLVD
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-4621
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Country | US
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Telephone | 817-281-3386
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Fax | 817-281-9287
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Provider Business Mailing Address
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Address Line | 111 E 4TH ST STE 440
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City | ALTON
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State | IL
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Zip | 62002-6241
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Country | US
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Telephone | 618-462-9818
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Fax | 314-741-4947
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 03329TG
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 03329TG
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License Number State | TX
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