Provider Demographics
NPI:1205275609
Name:MONTANEZ, MARELLI (DO)
Entity type:Individual
Prefix:
First Name:MARELLI
Middle Name:
Last Name:MONTANEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 FANNIN ST STE 755
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1934
Mailing Address - Country:US
Mailing Address - Phone:713-658-0358
Mailing Address - Fax:713-658-9414
Practice Address - Street 1:7400 FANNIN ST STE 755
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054
Practice Address - Country:US
Practice Address - Phone:713-658-0358
Practice Address - Fax:713-658-9414
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR8623207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology