Provider Demographics
NPI:1316983893
Name:MONTANI, NORBERTO J C (MD)
Entity type:Individual
Prefix:MR
First Name:NORBERTO
Middle Name:J C
Last Name:MONTANI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:200 N CARRIER PKWY
Mailing Address - Street 2:STE 109
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050
Mailing Address - Country:US
Mailing Address - Phone:972-264-4221
Mailing Address - Fax:972-266-9063
Practice Address - Street 1:200 N CARRIER PKWY
Practice Address - Street 2:STE 109
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050
Practice Address - Country:US
Practice Address - Phone:972-264-4221
Practice Address - Fax:972-266-9063
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2014-07-08
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Provider Licenses
StateLicense IDTaxonomies
TXD7640207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122994001Medicaid
TX122994001Medicaid
B24970Medicare UPIN