Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | E8739 | TX |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | E8739 | TX |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | E8739 | TX |
N | 207XX0801X | Orthopaedic Trauma Surgeon | E8739 | TX |
NPI | 1467458570 |
---|---|
Provider Name | James B Montgomery |
First Address | Dallas, TX 75231-5100 |
Second Address | Dallas, TX 75231-5100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 02/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123210004 | (05) | TX |
89033F | BCBS (01) | TX |
8BZ905 | BCBS (01) | TX |
D67423 | (02) |