Provider Demographics
NPI:1013968320
Name:MONTEMAYOR-GARCIA, SARA (MS, CCC, SLP)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:MONTEMAYOR-GARCIA
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5211 N MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2202
Mailing Address - Country:US
Mailing Address - Phone:956-630-6112
Mailing Address - Fax:956-683-9504
Practice Address - Street 1:5211 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2202
Practice Address - Country:US
Practice Address - Phone:956-630-6112
Practice Address - Fax:956-683-9504
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18609235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
84341TOtherBCBS
122871OtherSUPERIOR HEALTHPLAN
TX0055352-01Medicaid