Healthcare Provider Details

I. General information

NPI: 1326114976
Provider Name (Legal Business Name): PEDRO S MONTANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 05/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 PECAN BLVD STE B
MCALLEN TX
78501-4214
US

IV. Provider business mailing address

1209 S 10TH ST STE A 725
MCALLEN TX
78501-5059
US

V. Phone/Fax

Practice location:
  • Phone: 956-686-3375
  • Fax: 855-388-3037
Mailing address:
  • Phone: 956-686-3375
  • Fax: 956-686-1314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberF7849
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberF7849
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberF7849
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberF7849
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: