Provider Demographics
NPI:1467458570
Name:MONTGOMERY, JAMES B (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
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 1:7115 GREENVILLE AVE
Mailing Address - Street 2:STE 310
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5100
Mailing Address - Country:US
Mailing Address - Phone:214-265-3200
Mailing Address - Fax:
Practice Address - Street 1:7115 GREENVILLE AVE
Practice Address - Street 2:STE 310
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5100
Practice Address - Country:US
Practice Address - Phone:214-265-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8739207X00000X, 207XS0114X, 207XX0005X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BZ905OtherBCBS
TX123210004Medicaid
TX89033FOtherBCBS
D67423Medicare UPIN
TX89033FMedicare PIN
TX89033FOtherBCBS