MEDICARE: DR. WILLIAM ATTERBURY MONTGOMERY PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	25043	TX

General Provider Information

NPI Number	:	1063467306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM ATTERBURY MONTGOMERY PH.D.

Provider Business Mailing Address
First Line	:	2501 DENA DR
Second Line	:
City	:	SAN ANGELO
State	:	TX
Zip	:	76904-5014
Country	:	US
Telephone Number	:	325-223-0786
Fax Number	:	325-617-4196

Provider Business Practice Location Address
First Line	:	2501 DENA DR
Second Line	:
City	:	SAN ANGELO
State	:	TX
Zip	:	76904-5014
Country	:	US
Telephone Number	:	325-223-0786
Fax Number	:	325-617-4196

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	06/12/2024

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