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General NPI Number Information
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NPI Number | 1568333110
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Entity Type | Individual
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Provider Name | LISA S MONTGOMERY M.ED.
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Gender | Female
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 100 N CENTRAL EXPY STE 1250
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City | DALLAS
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State | TX
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Zip | 75201-4390
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Country | US
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Telephone | 214-497-8125
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Fax |
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Provider Business Mailing Address
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Address Line | 6934 DALHART LN
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City | DALLAS
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State | TX
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Zip | 75214-2822
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Country | US
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Telephone |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | TX
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