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NPI Code Detail

MEDICARE: DR. RACHEL EUBANK MONTGOMERY DDS

MEDICARE: DR. RACHEL EUBANK MONTGOMERY DDS
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
1122300000XDentist21598MA
21223P0221XPediatric Dentistry21598MA
31223P0221XPediatric DentistryDS037419PA
41223P0221XPediatric Dentistry22364TX

General Provider Information

NPI Number : 1659447001
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RACHEL EUBANK MONTGOMERY DDS
Provider Business Mailing Address
First Line : 2700 S 1ST ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-5421
Country : US
Telephone Number : 832-755-6458
Fax Number :
Provider Business Practice Location Address
First Line : 2700 S 1ST ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-5421
Country : US
Telephone Number : 832-755-6458
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 12/07/2020

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