Provider Demographics
NPI:1255332037
Name:MONTEMAYOR, PATRICIA C (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:C
Last Name:MONTEMAYOR
Suffix:
Gender:F
Credentials:MD
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 847408
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7408
Mailing Address - Country:US
Mailing Address - Phone:512-260-4900
Mailing Address - Fax:512-260-4910
Practice Address - Street 1:1007 S HIGHWAY 183
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-1989
Practice Address - Country:US
Practice Address - Phone:512-260-4900
Practice Address - Fax:512-260-4910
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31609207V00000X
TXJ3357207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ815110Medicaid
AZ7920466OtherAETNA
AZ0770270OtherBCBS
AZ2Z1955OtherHEALTHNET
AZ102822Medicare ID - Type Unspecified
AZ0770270OtherBCBS