Provider Demographics
NPI:1366282204
Name:MONTAGUE, GARRETT (PT, DPT)
Entity type:Individual
Prefix:
First Name:GARRETT
Middle Name:
Last Name:MONTAGUE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27525 VELVET SKY WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4150
Mailing Address - Country:US
Mailing Address - Phone:678-986-7248
Mailing Address - Fax:
Practice Address - Street 1:401 GREENS RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-2101
Practice Address - Country:US
Practice Address - Phone:281-873-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1393226225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist