Healthcare Provider Details

I. General information

NPI: 1720751415
Provider Name (Legal Business Name): ALLISON MONTALBANO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17520 W GRAND PKWY S STE 110
SUGAR LAND TX
77479-4759
US

IV. Provider business mailing address

17520 W GRAND PKWY S STE 110
SUGAR LAND TX
77479-4759
US

V. Phone/Fax

Practice location:
  • Phone: 281-239-3777
  • Fax:
Mailing address:
  • Phone: 281-239-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA14829
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: