Provider Demographics
NPI:1639168263
Name:MONTEMAYOR, LENIBET MIRIAM (MD)
Entity Type:Individual
Prefix:
First Name:LENIBET
Middle Name:MIRIAM
Last Name:MONTEMAYOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LENIBET
Other - Middle Name:MIRIAM
Other - Last Name:TAPIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2961 MOSSROCK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5119
Mailing Address - Country:US
Mailing Address - Phone:210-731-4800
Mailing Address - Fax:210-731-4810
Practice Address - Street 1:1802 SW MILITARY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1431
Practice Address - Country:US
Practice Address - Phone:210-924-2337
Practice Address - Fax:210-923-2208
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2146207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX471695YNA7Medicare PIN
TXI46116Medicare UPIN
TX8L27285Medicare PIN
TX8K9698Medicare PIN