Provider Demographics
NPI:1912030412
Name:MONTEMAYOR, ROLAND GARZA JR (OD)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:GARZA
Last Name:MONTEMAYOR
Suffix:JR
Gender:M
Credentials:OD
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Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:14637 MEMORIAL DR STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-7522
Practice Address - Country:US
Practice Address - Phone:832-770-4926
Practice Address - Fax:281-741-4991
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2023-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX3367T152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX903156Medicaid
TX903156Medicaid
TXU14087Medicare UPIN