Provider Demographics
NPI:1699455840
Name:MONTEZ & CO. ADULLAM HOUSE PLLC
Entity type:Organization
Organization Name:MONTEZ & CO. ADULLAM HOUSE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND LEAD CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT-ASSOCIATE
Authorized Official - Phone:254-397-2219
Mailing Address - Street 1:1109 DRY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-7168
Mailing Address - Country:US
Mailing Address - Phone:334-324-7416
Mailing Address - Fax:
Practice Address - Street 1:2201 S W S YOUNG DR STE 114-A104
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5375
Practice Address - Country:US
Practice Address - Phone:254-397-2219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty