Individual
DR. SAMUEL JAMES MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5007
(972) 715-5682
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E1067
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050065948
RAILROAD MEDICARE
TX
05
—
128571002
—
TX
05
—
128571006
—
TX
05
—
128571007
—
TX
05
—
128571008
—
TX
05
—
322183002
—
TX
01
—
83763K
BCBS
TX
01
—
8888UG
BCBS TX
TX
Enumeration date
12/19/2005
Last updated
11/02/2015
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