Provider Demographics
NPI:1972296077
Name:MONT BELVIEU PROVIDERS, PLLC
Entity Type:Organization
Organization Name:MONT BELVIEU PROVIDERS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-385-8111
Mailing Address - Street 1:9235 N HIGHWAY 146 STE 2
Mailing Address - Street 2:
Mailing Address - City:MONT BELVIEU
Mailing Address - State:TX
Mailing Address - Zip Code:77523-9503
Mailing Address - Country:US
Mailing Address - Phone:281-385-8111
Mailing Address - Fax:
Practice Address - Street 1:9235 N HIGHWAY 146 STE 2
Practice Address - Street 2:
Practice Address - City:MONT BELVIEU
Practice Address - State:TX
Practice Address - Zip Code:77523-9503
Practice Address - Country:US
Practice Address - Phone:281-385-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty