Individual
DAVA MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1349 EMPIRE CENTRAL DR, SUITE 516, DALLAS, TX 75247-4066
(469) 364-8600
(817) 789-6849
Mailing address
5316 TRAIL LAKE DR, FORT WORTH, TX 76133-1931
(817) 292-8787
(817) 789-6849
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
19507
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
05
—
207164901
—
TX
Enumeration date
02/04/2013
Last updated
02/04/2013
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