Individual
TAYDE ANALY CONTRERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
4509 WAITS AVE, FORT WORTH, TX 76133-1540
(817) 412-1836
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13405450-9934
UT
Other
Enumeration date
06/13/2023
Last updated
06/13/2023
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