Provider Demographics
NPI:1235442815
Name:MONTALVO, MONICA M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:M
Last Name:MONTALVO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6030 MONTGOMERY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-3233
Mailing Address - Country:US
Mailing Address - Phone:210-657-0322
Mailing Address - Fax:210-599-3485
Practice Address - Street 1:6030 MONTGOMERY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-3233
Practice Address - Country:US
Practice Address - Phone:210-657-0322
Practice Address - Fax:210-599-3485
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist