MEDICARE: JAMES B MONTGOMERY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	E8739	TX
2	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	E8739	TX
3	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	E8739	TX
4	207XX0801X	Orthopaedic Trauma Physician	E8739	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8BZ905	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	89033F	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1467458570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES B MONTGOMERY M.D.

Provider Business Mailing Address
First Line	:	7115 GREENVILLE AVE
Second Line	:	STE 310
City	:	DALLAS
State	:	TX
Zip	:	75231-5100
Country	:	US
Telephone Number	:	214-265-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	7115 GREENVILLE AVE
Second Line	:	STE 310
City	:	DALLAS
State	:	TX
Zip	:	75231-5100
Country	:	US
Telephone Number	:	214-265-3200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	02/02/2010

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Directions to “ JAMES B MONTGOMERY M.D.” Practice Location

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