Provider Demographics
NPI:1093379695
Name:PICHARDO, MONTZERRAT
Entity type:Individual
Prefix:
First Name:MONTZERRAT
Middle Name:
Last Name:PICHARDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 TOWN AND COUNTRY BLVD APT 141
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3985
Mailing Address - Country:US
Mailing Address - Phone:956-701-8647
Mailing Address - Fax:
Practice Address - Street 1:811 TOWN AND COUNTRY BLVD APT 141
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3985
Practice Address - Country:US
Practice Address - Phone:956-701-8647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)