1295802163 NPI number — MRS. BELINDA FLEMING MONTZ SLP

Table of content: MRS. BELINDA FLEMING MONTZ SLP (NPI 1295802163)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295802163 NPI number — MRS. BELINDA FLEMING MONTZ SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONTZ
Provider First Name:
BELINDA
Provider Middle Name:
FLEMING
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLEMING
Provider Other First Name:
BELINDA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1295802163
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3111 VAQUERO PASS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78247-2830
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-736-5148
Provider Business Mailing Address Fax Number:
210-981-1191

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6025B FOUNTAINWOOD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78233-4417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-802-6612
Provider Business Practice Location Address Fax Number:
210-981-1191
Provider Enumeration Date:
11/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  102936 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 050551331 . This is a "TAX ID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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