Provider Demographics
NPI:1326114976
Name:MONTANO, PEDRO S (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:S
Last Name:MONTANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 S 10TH ST
Mailing Address - Street 2:STE A 725
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-5059
Mailing Address - Country:US
Mailing Address - Phone:956-686-3375
Mailing Address - Fax:956-686-1314
Practice Address - Street 1:1623 PECAN BLVD STE B
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4214
Practice Address - Country:US
Practice Address - Phone:956-686-3375
Practice Address - Fax:855-388-3037
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7849207Q00000X, 207KA0200X, 237700000X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00EY77OtherMEDICARE PTAN
TX040001655OtherRAILROAD MEDICARE
TX120648406Medicaid
TX120648408Medicaid
TX120648405Medicaid