Organization Active NPI

Montage Surgical, PLLC

  • Physician Assistant
  • Plano, TX
National Provider Identifier
1417523465
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
MONTAGE SURGICAL, PLLC
Practice address
6200 Preston Rd., Suite 300a
Plano, TX 75024
Phone
(210) 598-4262
NPI assigned
Jun 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Roxanna Laroque
Title
Director of Client Experience
Phone
(210) 598-4277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

6200 Preston Rd., Suite 300a
Plano, TX 75024

Mailing address

1141 N Loop 1604 E #105-612
San Antonio, TX 78232
Phone (210) 598-4262

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1417523465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 N LOOP 1604 E #105-612",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78232",
            "telephone_number": "210-598-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 PRESTON RD., SUITE 300A",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75024",
            "telephone_number": "210-598-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTAGE SURGICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-01",
        "last_updated": "2024-09-24",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "LAROQUE",
        "authorized_official_first_name": "ROXANNA",
        "authorized_official_title_or_position": "DIRECTOR OF CLIENT EXPERIENCE",
        "authorized_official_telephone_number": "210-598-4277"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.