Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | H9549 | TX |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | H9549 | TX |
NPI | 1295728293 |
---|---|
Provider Name | Dr. Baxter D Montgomery |
First Address | Houston, TX 77225-0808 |
Second Address | Houston, TX 77025-5500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 06/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
081027701 | (05) | TX |
10018324 | AMERIGROUP (01) | TX |
132190301 | (05) | TX |
5034595 | AETNA (01) | TX |
85680F | BLUE CROSS/BLUE SHIELD (01) | TX |
F87839 | (02) | TX |