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NPI Code Detail

MEDICARE: MAUREEN O'BRYAN MONTGOMERY MD

MEDICARE: MAUREEN O'BRYAN MONTGOMERY MD
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
12084P0800XPsychiatry PhysicianW4905TX

General Provider Information

NPI Number : 1760048912
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN O'BRYAN MONTGOMERY MD
Provider Business Mailing Address
First Line : 1430 EMPIRE CENTRAL DR
Second Line :
City : DALLAS
State : TX
Zip : 75247-4032
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1430 EMPIRE CENTRAL DR
Second Line :
City : DALLAS
State : TX
Zip : 75247-4032
Country : US
Telephone Number : 214-645-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2019
Last Update Date : 05/26/2026

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