Provider Demographics
NPI:1962404822
Name:MORRIS, MONTY G (PA-C)
Entity type:Individual
Prefix:MR
First Name:MONTY
Middle Name:G
Last Name:MORRIS
Suffix:
Gender:M
Credentials:PA-C
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:JUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:76247-0068
Mailing Address - Country:US
Mailing Address - Phone:940-648-9900
Mailing Address - Fax:940-648-1600
Practice Address - Street 1:310 W 2ND ST
Practice Address - Street 2:
Practice Address - City:JUSTIN
Practice Address - State:TX
Practice Address - Zip Code:76247-5023
Practice Address - Country:US
Practice Address - Phone:940-648-9900
Practice Address - Fax:940-648-1600
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02619363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical