Provider Demographics
NPI:1679875934
Name:MONTANEZ CONCEPCION, ANA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:M
Last Name:MONTANEZ CONCEPCION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:M
Other - Last Name:MONTANEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2627 DOLCETTO GRV
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-1862
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23 MANHATTAN SQ
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5843
Practice Address - Country:US
Practice Address - Phone:757-668-2216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD83967208000000X
PR28082-R208000000X
NDPT12512208000000X
VA0101258397208000000X
TXU1536208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU1536OtherSTATE ISSUED UNRESTRICTED MEDICAL LICENSE
MDD83967OtherSTATE ISSUED UNRESTRICTED MEDICAL LICENSE