Individual
MR. WILLIAM FRANKLIN MONTGOMERY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2401 WALKER PLACE BLVD, COPPERAS COVE, TX 76522-4025
(254) 547-5516
(254) 547-5258
Mailing address
2401 WALKER PLACE BLVD, COPPERAS COVE, TX 76522-4025
(254) 547-5516
(254) 547-5258
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00108
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86N594
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
07/12/2006
Last updated
02/17/2011
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