Provider Demographics
NPI:1417959040
Name:MONTGOMERY, CURTIS EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:EDWARD
Last Name:MONTGOMERY
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 1:100 MEDICAL CENTER PKWY
Mailing Address - Street 2:STE 500
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4945
Mailing Address - Country:US
Mailing Address - Phone:936-291-0614
Mailing Address - Fax:936-291-0354
Practice Address - Street 1:100 MEDICAL CENTER PKWY
Practice Address - Street 2:STE 500
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4945
Practice Address - Country:US
Practice Address - Phone:936-291-0614
Practice Address - Fax:936-291-0354
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7591207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031511101Medicaid
A48057Medicare UPIN
TX00966JMedicare ID - Type Unspecified