Provider Demographics
NPI:1669693883
Name:MONTOYA, ELVA JUANITA (MD)
Entity type:Individual
Prefix:DR
First Name:ELVA
Middle Name:JUANITA
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9329 CHIMNEY SWEEP LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3237
Mailing Address - Country:US
Mailing Address - Phone:214-476-4483
Mailing Address - Fax:
Practice Address - Street 1:9329 CHIMNEY SWEEP LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3237
Practice Address - Country:US
Practice Address - Phone:214-476-4483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1486208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics