Provider Demographics
NPI:1689760365
Name:MONTS, MOYNE KORNMAN (MD)
Entity type:Individual
Prefix:DR
First Name:MOYNE
Middle Name:KORNMAN
Last Name:MONTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MOYNE
Other - Middle Name:TREAT
Other - Last Name:KORNMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1106 N. 6TH STREET
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601
Mailing Address - Country:US
Mailing Address - Phone:903-757-3223
Mailing Address - Fax:844-315-0256
Practice Address - Street 1:1106 N. 6TH STREET
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601
Practice Address - Country:US
Practice Address - Phone:903-757-3223
Practice Address - Fax:844-315-0256
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9898207ZB0001X, 207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203671702Medicaid
TXTXB147433Medicare PIN