MR. CARLOS SANTANA MONTALVO (NPI# 1114133113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114133113 |
| Entity Type | Individual |
| Full Name | MR. CARLOS SANTANA MONTALVO |
| Credential | IDC |
| Practice Address |
4508 Timken Trl Fort Worth TX 76137-6144 |
| Mailing Address |
11268 Woodrush Ln San Diego CA 92128-3604 |
| Practice Telephone | 8177825914 |
| Mailing Telephone | 6196474459 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 124Q00000X | Dental Hygienist | Dental Providers | ||
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11268 Woodrush Ln, San Diego, CA 921283604 | 6196474459 | 6196474459 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518351220 | Carlos Roberto Montalvo | Case Manager/Care Coordinator | 53 E Glenaven Ave, Youngstown, OH 44507-1304 | 2015-03-20 |
| 1780941468 | Carlos N Montalvo | Anesthesiology | 50 Calle Arrecife, Dorado, PR 00646 | 2012-04-18 |
| 1669724076 | Carlos Montalvo | Social Worker | 1216 Arch St, 6th Floor, Philadelphia, PA 19107-2835 | 2012-10-09 |
| Street Address |
4508 TIMKEN TRL |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76137-6144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962975581 | Rose Kabera | Registered Nurse | 8021 Jolie Dr, Fort Worth, TX 76137 | 2019-01-07 |
| 1043786569 | Grace-marie Jones | Licensed Vocational Nurse | 5201 Endicott Avenue, Fort Worth, TX 76137 | 2018-10-23 |
| 1104327683 | Jeris Taylor | Registered Nurse | 4144 Heritage Way Dr, Fort Worth, TX 76137 | 2018-02-21 |
| 1396269429 | Matthew Pedroza | Dentist | 4625 Feathercrest Dr., Fort Worth, TX 76137 | 2017-07-31 |
| 1447789896 | Texas Surgical Ally | Physician Assistant | 6677 Friendsway Dr, Fort Worth, TX 76137 | 2017-06-08 |
| 1992249239 | Tracy Kirk Dds, Pllc | Dentist | 6300 N. Beach St, Ft Worth, TX 76137 | 2016-12-06 |
| 1992103295 | Keller Modern Dentistry and Orthodontics, PC | Dentist | 5701 N. Tarrant Pkwy, Suite 101, Fort Worth, TX 76137 | 2014-12-18 |
| 1619380805 | Ikids Pediatric Dentistry and Orthodontics Nfw | Dentist | 7451 N Beach St, Ste 140, Fort Worth, TX 76137 | 2014-06-05 |
| 1205246758 | Jack Milton Curlee Jr. | Counselor | 3629 Western Center Blvd., Suite 211, Fort Worth, TX 76137 | 2014-05-06 |
| 1932457363 | Milestone Dental of Keller, Pllc | Dentist | 5800 North Tarrant Parkway, Suite 102, Fort Worth, TX 76137 | 2012-08-15 |
| Find all providers in zip 76137 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487079356 | Jacob Alan Seekins | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2014-02-28 |
| 1417389461 | Michael A Rivard | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2013-08-01 |
| 1609168996 | Richard Thomas Gilbert | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2011-05-05 |
| 1124235445 | John David Brabner | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1711 | 2007-05-17 |
| 1669427290 | Richard Brian Butorac | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76179 | 2006-05-23 |
| 1356318315 | James Kevin Campbell | Military Health Care Provider | 1711 Doolittle Ave, Fort Worth, TX 76127-1133 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225581481 | Kenneth Perry Vantassel | Military Health Care Provider | 1410 Woodfair Dr, Richmond, TX 77406-6609 | 2016-07-24 |
| 1528430980 | Tomasz Orent | Military Health Care Provider | 26885 Manor Falls Dr, Kingwood, TX 77339-7709 | 2015-10-26 |
| 1518337013 | John Cantu | Military Health Care Provider | 3945 Tripoli Dr, Corpus Christi, TX 78415-3348 | 2015-09-28 |
| 1699144428 | Alberto Gonzalez | Military Health Care Provider | 102 Redrock Dr, San Antonio, TX 78213-4526 | 2015-09-22 |
| 1275938375 | Ricardo Jaramillo | Military Health Care Provider | 7016 Austrian Pine, Brownsville, TX 78526 | 2014-10-31 |
| 1942637087 | Matthew Alan Robichaux | Military Health Care Provider | 13500 White Tail Trl, Austin, TX 78736-7422 | 2013-10-03 |
| 1417223710 | Adam Anthony Garcia | Military Health Care Provider | 12080 Paseo De Amor Ln, El Paso, TX 79936-4499 | 2012-03-30 |
| 1124306329 | David G Morales Jr. | Military Health Care Provider | 9180 Tenango Dr, El Paso, TX 79907-3257 | 2011-07-22 |
| 1689970535 | Michael G. Phillips | Military Health Care Provider | 2621 Las Brisas St, Corpus Christi, TX 78414-5014 | 2011-02-09 |
| 1912208216 | Shepley Allen Reimer | Military Health Care Provider | 3555 Patch Rd, Fort Sam Houston, TX 78234-1200 | 2010-11-03 |
| Find all providers with the same taxonomy | ||||
| City | FORT WORTH |
| Zip Code | 76137 |
Please comment or provide details below to improve the information on MR. CARLOS SANTANA MONTALVO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.