Provider Demographics
NPI:1043357999
Name:MONTY, DAVID EDWARD (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:EDWARD
Last Name:MONTY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 345
Mailing Address - Street 2:
Mailing Address - City:GRAND SALINE
Mailing Address - State:TX
Mailing Address - Zip Code:75140-0345
Mailing Address - Country:US
Mailing Address - Phone:903-962-4559
Mailing Address - Fax:903-962-6418
Practice Address - Street 1:132 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAND SALINE
Practice Address - State:TX
Practice Address - Zip Code:75140-1844
Practice Address - Country:US
Practice Address - Phone:903-962-4559
Practice Address - Fax:903-962-6418
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7318111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605771OtherBCBS
TXU68852Medicare UPIN
TX609000Medicare PIN