Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | J0604 | TX |
NPI | 1013919810 |
---|---|
Provider Name | Dr. Louis Montanaro III |
First Address | Carrollton, TX 75010-4602 |
Second Address | Carrollton, TX 75010-4602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D42671 | (02) | TX |