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NPI Code Detail

MEDICARE: TRISTAN MONTRALE WASHINGTON M.D.

MEDICARE: TRISTAN MONTRALE WASHINGTON 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
1208M00000XHospitalist PhysicianS8262TX
2207Q00000XFamily Medicine PhysicianS8262TX

General Provider Information

NPI Number : 1790196616
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRISTAN MONTRALE WASHINGTON M.D.
Provider Business Mailing Address
First Line : PO BOX 7411009
Second Line :
City : CHICAGO
State : IL
Zip : 60674-3009
Country : US
Telephone Number : 609-585-1122
Fax Number :
Provider Business Practice Location Address
First Line : 1401 ST JOSEPH PKWY
Second Line :
City : HOUSTON
State : TX
Zip : 77002-8301
Country : US
Telephone Number : 609-585-1122
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2014
Last Update Date : 03/23/2026

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Directions to “ TRISTAN MONTRALE WASHINGTON M.D.” Practice Location

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