Provider Demographics
NPI:1730814336
Name:BONTRAGER, MARIA (OD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:BONTRAGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 HWY 290 E
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:TX
Mailing Address - Zip Code:78621-1400
Mailing Address - Country:US
Mailing Address - Phone:512-229-5911
Mailing Address - Fax:512-677-6282
Practice Address - Street 1:1320 HWY 290 E
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:TX
Practice Address - Zip Code:78621-1400
Practice Address - Country:US
Practice Address - Phone:512-229-5911
Practice Address - Fax:512-677-6282
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10528T152W00000X
SC2362152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist