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General NPI Number Information
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NPI Number | 1861671364
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Entity Type | Individual
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Provider Name | EUSEBIO M MONTEJO M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 122 SAINT CLOUD RD
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City | SAN ANTONIO
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State | TX
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Zip | 78228-5009
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Country | US
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Telephone | 726-240-6949
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Fax | 210-761-3397
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Provider Business Mailing Address
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Address Line | 6101 BLUE LAGOON DR STE 200
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City | MIAMI
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State | FL
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Zip | 33126-3168
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Country | US
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Telephone | 407-533-6836
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Fax | 407-770-0661
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A95635
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N3905
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License Number State | TX
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