Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | AP132883 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP132883 | TX |
NPI | 1003352246 |
---|---|
Provider Name | Miss Bianca Elena Montes |
First Address | San Antonio, TX 78230-4735 |
Second Address | San Antonio, TX 78230-4735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2017 |
Last Update Date | 05/11/2020 |