Provider Demographics
NPI:1932544723
Name:MONTEZ, CALLIE DEANN (MD)
Entity Type:Individual
Prefix:DR
First Name:CALLIE
Middle Name:DEANN
Last Name:MONTEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5951 JEFFERSON ST NE STE C
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3450
Mailing Address - Country:US
Mailing Address - Phone:505-247-4900
Mailing Address - Fax:505-933-6373
Practice Address - Street 1:5951 JEFFERSON ST NE STE C
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3450
Practice Address - Country:US
Practice Address - Phone:505-247-4900
Practice Address - Fax:505-933-6373
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR24202084P0800X
MN755312084P0800X
NMMD2023-13042084P0800X
COCDRH.00636562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR2420OtherMEDICAL LICENSE