MEDICARE: DR. LAURA IGLESIAS MONTES 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
1	207Q00000X	Family Medicine Physician	R2177	TX
2	390200000X	Student in an Organized Health Care Education/Training Program	BP10051249	TX
3	207QB0002X	Obesity Medicine (Family Medicine) Physician	R2177	TX

General Provider Information

NPI Number	:	1780096842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA IGLESIAS MONTES MD

Provider Business Mailing Address
First Line	:	7017 N 10TH ST STE N2
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-3288
Country	:	US
Telephone Number	:	956-605-6104
Fax Number	:	956-783-0291

Provider Business Practice Location Address
First Line	:	1700 W DOVE AVE STE 80
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-4464
Country	:	US
Telephone Number	:	956-608-6700
Fax Number	:	956-783-0291

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

Provider Enumeration Date	:	05/23/2014
Last Update Date	:	11/02/2021

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