Healthcare Provider Details

I. General information

NPI: 1588737670
Provider Name (Legal Business Name): RICHARD ANDREW MONTES D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1081 KINWEST PKWY #110
IRVING TX
75063-3407
US

IV. Provider business mailing address

4141 ROBERTS RD
GRAPEVINE TX
76051-6597
US

V. Phone/Fax

Practice location:
  • Phone: 972-401-2345
  • Fax:
Mailing address:
  • Phone: 817-858-9983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6576
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: