Individual provider Active NPI

Raven Montallana

  • Student in an Organized Health Care Education/Training Program
  • Round Rock, TX
National Provider Identifier
1699645648
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
301 Seton Pkwy Ste 203
Round Rock, TX 78665-8003
Phone
(818) 472-8608
NPI assigned
Nov 6, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X Primary

Addresses

Primary practice location

301 Seton Pkwy Ste 203
Round Rock, TX 78665-8003

Mailing address

301 Seton Pkwy Ste 203
Round Rock, TX 78665-8003

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

NPI Registry JSON

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

{
    "created_epoch": "1762387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1699645648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SETON PKWY STE 203",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786658003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SETON PKWY STE 203",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786658003",
            "telephone_number": "818-472-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTALLANA",
        "first_name": "RAVEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.