| Montgomery Xpress Chiropractic Pllc | |
|
116 E Heritage Dr. Ste 105 Tyler TX 75703-5159 | |
| (903) 787-7529 | |
| (903) 787-7530 |
| Full Name | Montgomery Xpress Chiropractic Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 116 E Heritage Dr., Tyler, Texas |
| Authorized Official Name and Position | Matthew Montgomery (OWNER, STAFF DOCTOR) |
| Authorized Official Contact | 9037877529 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montgomery Xpress Chiropractic Pllc 116 E Heritage Dr Ste 105 Tyler TX 75703-5150 Ph: (903) 787-7529 | Montgomery Xpress Chiropractic Pllc 116 E Heritage Dr. Ste 105 Tyler TX 75703-5159 Ph: (903) 787-7529 |
| NPI Number | 1669719498 |
|---|---|
| Provider Enumeration Date | 01/14/2013 |
| Last Update Date | 03/10/2016 |
| Medicare PECOS PAC ID | 5395970792 |
|---|---|
| Medicare Enrollment ID | O20131019000060 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669719498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 12201 (Texas) | Primary |
| Provider Name | Matthew Harrison Montgomery |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811233703 PECOS PAC ID: 6204061609 Enrollment ID: I20131021000881 |
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