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NPI Code Detail

MEDICARE: THERESA E MONTOYA LMSW

MEDICARE: THERESA E MONTOYA LMSW
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
11041C0700XClinical Social Worker66580UT
21041C0700XClinical Social Worker66580TX

General Provider Information

NPI Number : 1932971272
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA E MONTOYA LMSW
Provider Business Mailing Address
First Line : 14162 COQUINA BAY AVE
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78418-6563
Country : US
Telephone Number : 361-608-8245
Fax Number :
Provider Business Practice Location Address
First Line : 5934 S STAPLES ST STE 230
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78413-3800
Country : US
Telephone Number : 361-608-8245
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2023
Last Update Date : 09/29/2024

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Directions to “ THERESA E MONTOYA LMSW” Practice Location

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