Provider Demographics
NPI:1689627366
Name:MONTY R. SCOTT DC, P.A.
Entity Type:Organization
Organization Name:MONTY R. SCOTT DC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONTY
Authorized Official - Middle Name:REESE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:432-758-5786
Mailing Address - Street 1:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:TX
Mailing Address - Zip Code:79360-0488
Mailing Address - Country:US
Mailing Address - Phone:432-758-5786
Mailing Address - Fax:432-758-3348
Practice Address - Street 1:211 NE 2ND ST
Practice Address - Street 2:SUITE A
Practice Address - City:SEMINOLE
Practice Address - State:TX
Practice Address - Zip Code:79360-3603
Practice Address - Country:US
Practice Address - Phone:432-758-5786
Practice Address - Fax:432-758-3348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10079111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV07048Medicare UPIN