Active NPI
Randy Joe Montgomery, MD
- Ophthalmology Physician
- Fort Worth, TX
National Provider Identifier
1033170667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- H1000
- Practice address
- 4825 Camp Bowie Blvd
Fort Worth, TX 76107-4150 - Phone
- (817) 336-2010
- Fax
- (817) 377-0074
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | H1000 | TX | Primary |
Addresses
Primary practice location
4825 Camp Bowie Blvd
Fort Worth, TX 76107-4150
Mailing address
4825 Camp Bowie Blvd
Fort Worth, TX 76107-4150
Phone (817) 336-2010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H1000 | TX | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237334400000",
"number": "1033170667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4825 CAMP BOWIE BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761074150",
"telephone_number": "817-336-2010",
"fax_number": "817-377-0074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4825 CAMP BOWIE BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761074150",
"telephone_number": "817-336-2010",
"fax_number": "817-377-0074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "RANDY",
"middle_name": "JOE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2009-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TX",
"license": "H1000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
- Gary Mark Montgomery, MD
- Katherine Montgomery
- Kimberly Dawn Montgomery, AGACNP
- Kylie Ann Montgomery, RBT
- Lyndsey Montgomery
- Sarah Montgomery, OTR
- Tiffany Christeen Montgomery, MOT
- Vanessa Jean Montgomery, PHARMD
- Monticello Chiropractic PLLC
- Monticello Diagnostic Imaging LP (Elite Diagnostic Imaging)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.