Provider Demographics
NPI:1386704054
Name:MONTEMAYOR, IRMA ELENA (MD)
Entity type:Individual
Prefix:DR
First Name:IRMA
Middle Name:ELENA
Last Name:MONTEMAYOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 420847
Mailing Address - Street 2:106 FOSTER DRIVE
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78842-0847
Mailing Address - Country:US
Mailing Address - Phone:830-778-8442
Mailing Address - Fax:830-778-8321
Practice Address - Street 1:106 FOSTER DR
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-2757
Practice Address - Country:US
Practice Address - Phone:830-778-8442
Practice Address - Fax:830-778-8321
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK2539208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80511YOtherBLUE CROSS BLUE SHIELDS #
TXG66082Medicare UPIN
TX8212J0Medicare ID - Type UnspecifiedMEDICARE NUMBER