Provider Demographics
NPI:1861469603
Name:MONTGOMERY, JAMES CHESTER (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHESTER
Last Name:MONTGOMERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 CREEKDALE DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-3631
Mailing Address - Country:US
Mailing Address - Phone:817-416-7500
Mailing Address - Fax:817-416-7565
Practice Address - Street 1:1139 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7533
Practice Address - Country:US
Practice Address - Phone:817-416-7500
Practice Address - Fax:817-416-7500
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0154192084P0800X
TXJ83192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10020730ZMedicaid
TX10020730ZMedicaid
TX00T8ZFMedicare ID - Type Unspecified