Montgomery, Mark L.

Montgomery, Mark L. is an individual health care provider with primary practice located at 2401 S 31St St , Temple TX 76508-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Montgomery, Mark L. can be contacted via phone (254) 724-2111.

Contact Information

Primary practice address
2401 S 31St St Temple TX 76508-0001
Phone: (254) 724-2111
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X J6603 Texas
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X J6603 Texas

Profile Details

NPI number 1366403347
LBN Legal business name Montgomery, Mark L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2006
Last updated Jan 25th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366403347 NPPES
Texas Other 300115737 RR/MEDICARE
Texas Other 1050882-01 RR/MEDICARE
Texas MEDICAID 1050882-02 RR/MEDICARE
Texas Other 87433Y RR/MEDICARE

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