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General NPI Number Information
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NPI Number | 1477012284
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Entity Type | Individual
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Provider Name | ERICA L MONTGOMERY MSHA
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Gender | Female
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 23223 FIRST PARK DR APT 7306
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City | KATY
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State | TX
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Zip | 77449-2553
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Country | US
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Telephone | 228-284-7757
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 36542
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City | HOUSTON
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State | TX
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Zip | 77236-6542
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Country | US
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Telephone | 228-284-7757
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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