Organization
SOUTH MAIN CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALVARO PINILLA (PRESIDENT OWNER)
(713) 729-7600
Entity
Organization
Contact information
Practice address
12333 MAIN ST, HOUSTON, TX 77035-6205
(713) 729-7600
(713) 729-7603
Mailing address
12333 MAIN ST, HOUSTON, TX 77035-6205
(713) 729-7600
(713) 729-7603
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0087MG
BCBS
TX
01
—
1427078674
DR. MONTGOMERY NPI
TX
Enumeration date
07/20/2006
Last updated
04/20/2008
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