Basic Information
| Provider Information | |||||||||
| NPI: | 1558483099 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MONTES | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | OTR, ATP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14738 TIMBERGREEN DR | ||||||||
| Address2: | |||||||||
| City: | MAGNOLIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773558008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7138769801 | ||||||||
| FaxNumber: | 7139834600 | ||||||||
| Practice Location | |||||||||
| Address1: | 9220 KIRBY DR STE 700 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770542535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137911011 | ||||||||
| FaxNumber: | 7137911047 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2007 | ||||||||
| LastUpdateDate: | 04/13/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 109372 | TX | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 247200000X | Y | Technologists, Technicians & Other Technical Service Providers | Technician, Other |
ID Information
| ID | Type | State | Issuer | Description | 180182101 | 05 | TX | MEDICAID |