Active NPI
Russell Christopher Montalvo, LMT
- Massage Therapist
- College Station, TX
National Provider Identifier
1780910430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT107119
- Practice address
- 3975 State Highway 6 S Ste 700
College Station, TX 77845-5899 - Phone
- (979) 696-2000
- NPI assigned
- Oct 29, 2009
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT107119 | TX | Primary |
Addresses
Primary practice location
3975 State Highway 6 S Ste 700
College Station, TX 77845-5899
Mailing address
1411 Dayton CT
College Station, TX 77845-9496
Phone (512) 501-9032
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 |
|---|---|---|---|
| MT107119 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257292800000",
"number": "1780910430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 DAYTON CT",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778459496",
"telephone_number": "512-501-9032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3975 STATE HIGHWAY 6 S STE 700",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778455899",
"telephone_number": "979-696-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTALVO",
"first_name": "RUSSELL",
"middle_name": "CHRISTOPHER",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-29",
"last_updated": "2009-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT107119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.