MEDICARE: DR. ROMEO F MONTALVO JR. M.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	208000000X	Pediatrics Physician	E4537	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00HT72	OTHER	TX	BCBS OF TEXAS
2	139506100	OTHER	TX	VALLEY HEALTH PLANS
3	2319479	OTHER	TX	AETNA PROVIDER ID
4	116607	OTHER	TX	SUPERIOR CHIP
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346203502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROMEO F MONTALVO JR. M.D.

Provider Business Mailing Address
First Line	:	864 CENTRAL BLVD
Second Line	:	SUITE 2200
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-7551
Country	:	US
Telephone Number	:	956-541-8334
Fax Number	:	956-541-9738

Provider Business Practice Location Address
First Line	:	864 CENTRAL BLVD
Second Line	:	SUITE 2200
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-7551
Country	:	US
Telephone Number	:	956-541-8334
Fax Number	:	956-541-9738

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

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. ROMEO F MONTALVO JR. M.D.” Practice Location

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