Provider Demographics
NPI:1881369585
Name:TOTAL CARE OF MONTGOMERY PLLC
Entity type:Organization
Organization Name:TOTAL CARE OF MONTGOMERY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-290-0761
Mailing Address - Street 1:18441 TX 105 W
Mailing Address - Street 2:SUITE B
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-2859
Mailing Address - Country:US
Mailing Address - Phone:936-290-0761
Mailing Address - Fax:833-440-1361
Practice Address - Street 1:18441 HIGHWAY 105 W STE B
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-2859
Practice Address - Country:US
Practice Address - Phone:936-290-0761
Practice Address - Fax:833-440-1361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care