Provider Demographics
NPI:1851358584
Name:MONTAGUE, BARBARA L (MD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:L
Last Name:MONTAGUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF PSYCHIATRY ADDICTION MEDICINE FELLOWSHIP
Mailing Address - Street 2:5788 ECKHERT RD.
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-7792
Mailing Address - Country:US
Mailing Address - Phone:210-567-5440
Mailing Address - Fax:210-567-3483
Practice Address - Street 1:DEPARTMENT OF PSYCHIATRY ADDICTION MEDICINE FELLOWSHIP
Practice Address - Street 2:5788 ECKHERT RD.
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-7792
Practice Address - Country:US
Practice Address - Phone:325-245-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62913207Q00000X
TXL9371207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B2169OtherBLUE CROSS/BLUE SHIELD TX
TX167279201Medicaid
F01034Medicare UPIN
TX8B2169OtherBLUE CROSS/BLUE SHIELD TX