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General NPI Number Information
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NPI Number | 1487974085
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Entity Type | Individual
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Provider Name | NICOLE IRENE MONTGOMERY M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 6701 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-2608
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Country | US
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Telephone | 832-824-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1709 DRYDEN RD # 5.70
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City | HOUSTON
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State | TX
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Zip | 77030-2400
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Country | US
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Telephone | 713-798-0190
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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 | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | R1992
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | BP10037400
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License Number State | TX
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