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General NPI Number Information
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NPI Number | 1396210910
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Entity Type | Organization
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Legal Business Name | MONTGOMERY INTERNAL MEDICINE PLLC
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Dates
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Enumeration Date | 10/10/2018
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 425 HOLDERRIETH BLVD STE 108
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City | TOMBALL
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State | TX
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Zip | 77375-4551
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Country | US
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Telephone | 973-444-7123
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Fax |
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Provider Business Mailing Address
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Address Line | 11 SPRUCE CANYON PL
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City | THE WOODLANDS
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State | TX
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Zip | 77382-2758
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Country | US
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Telephone | 973-444-7123
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | APARNA METHUKU KURA
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Credential | MD
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Telephone | 973-444-7123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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