MEDICARE: DR. GUILLERMO L MONTANEZ JR. 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	174400000X	Specialist	H3711	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0071JA	OTHER	TX	BC/BS OF TEXAS

General Provider Information

NPI Number	:	1902878721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GUILLERMO L MONTANEZ JR. MD

Provider Business Mailing Address
First Line	:	PO BOX 2105
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78505-2105
Country	:	US
Telephone Number	:	956-631-8354
Fax Number	:	956-631-8441

Provider Business Practice Location Address
First Line	:	1200 E SAVANNAH AVE
Second Line	:	SUITE 18
City	:	MCALLEN
State	:	TX
Zip	:	78503-1727
Country	:	US
Telephone Number	:	956-631-8354
Fax Number	:	956-631-8441

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	07/18/2008

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