Provider Demographics
NPI:1952639700
Name:MONTGOMERY, TANASHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TANASHA
Middle Name:
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23110 ALDINE WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-7738
Mailing Address - Country:US
Mailing Address - Phone:281-350-5311
Mailing Address - Fax:281-350-1791
Practice Address - Street 1:23110 ALDINE WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-7738
Practice Address - Country:US
Practice Address - Phone:281-350-5311
Practice Address - Fax:281-350-1791
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist