Provider Demographics
NPI:1891582052
Name:MONTGOMERY, JEAN M
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:M
Last Name:MONTGOMERY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 HOLLANDBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-3518
Mailing Address - Country:US
Mailing Address - Phone:832-557-6761
Mailing Address - Fax:
Practice Address - Street 1:13700 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1026
Practice Address - Country:US
Practice Address - Phone:844-810-6289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty