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General NPI Number Information
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NPI Number | 1225903438
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Entity Type | Organization
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Legal Business Name | SMALL WONDER EYECARE PLLC
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 1320 W HWY 290 FRONTAGE ROAD
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City | ELGIN
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State | TX
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Zip | 78621
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Country | US
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Telephone | 512-229-5911
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Fax | 512-677-6282
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Provider Business Mailing Address
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Address Line | 459 WALTER HOFFMAN RD
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City | CEDAR CREEK
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State | TX
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Zip | 78612-3514
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Country | US
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Telephone | 512-229-5911
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Fax | 512-677-6282
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Authorized Official
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Title or Position | OWNER OPTOMETRIST
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Name | MARIA BONTRAGER
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Credential | OD
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Telephone | 512-229-5911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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