Basic Information
| Provider Information | |||||||||
| NPI: | 1689141178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MONTEMAYOR | ||||||||
| FirstName: | TRIANA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2408 FIR AVE | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785017515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566552634 | ||||||||
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| Practice Location | |||||||||
| Address1: | 508 W INTERSTATE 2 STE 3 | ||||||||
| Address2: | |||||||||
| City: | PHARR | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785776563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9565108777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2018 | ||||||||
| LastUpdateDate: | 11/01/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1278251 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.