Active NPI
Robert Montgomery Sr.
- Optician
- Lufkin, TX
National Provider Identifier
1164853453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DR4127
- Practice address
- 513 Gaslight Blvd
Lufkin, TX 75904-3127 - Phone
- (936) 238-3629
- Fax
- (936) 238-3769
- NPI assigned
- Dec 11, 2013
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | DR4127 | TX | Primary |
Addresses
Primary practice location
513 Gaslight Blvd
Lufkin, TX 75904-3127
Mailing address
513 Gaslight Blvd
Lufkin, TX 75904-3127
Phone (936) 238-3629
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR4127 | TX | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386720000000",
"number": "1164853453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "513 GASLIGHT BLVD",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043127",
"telephone_number": "936-238-3629",
"fax_number": "936-238-3769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "513 GASLIGHT BLVD",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043127",
"telephone_number": "936-238-3629",
"fax_number": "936-238-3769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "ROBERT",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-11",
"last_updated": "2013-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "TX",
"license": "DR4127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lufkin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.