Provider Demographics
NPI:1497134217
Name:MONTANEZ, YVONNE
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:MONTANEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 NORTHWEST PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3343
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6000 NORTHWEST PKWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3343
Practice Address - Country:US
Practice Address - Phone:210-581-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74-2730328282N00000X
TX74-2781812282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
1053683185Medicare UPIN
1124074273Medicare UPIN
1881648863Medicare UPIN
1245284223Medicare UPIN
1659525236Medicare UPIN
1679528889Medicare UPIN
1871560003Medicare UPIN
1720033947Medicare UPIN
1497903728Medicare UPIN
1649223645Medicare UPIN
1720025885Medicare UPIN
1629021845Medicare UPIN
1134166069Medicare UPIN
1184661217Medicare UPIN