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General NPI Number Information
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NPI Number | 1245413384
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Entity Type | Organization
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Legal Business Name | MJC VISION
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 10/10/2008
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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 | 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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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MARIO JOSEPH CONTALDI
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Credential | O.D.
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Telephone | 817-281-3386
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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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