Provider Demographics
NPI:1174567069
Name:SCOTT, MONTY REESE (DC)
Entity type:Individual
Prefix:
First Name:MONTY
Middle Name:REESE
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 73RD ST UNIT G
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1122
Mailing Address - Country:US
Mailing Address - Phone:806-598-2111
Mailing Address - Fax:
Practice Address - Street 1:3402 73RD ST UNIT G
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1122
Practice Address - Country:US
Practice Address - Phone:806-589-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10079111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX612638Medicare PIN
TXV07048Medicare UPIN
TX612035Medicare ID - Type Unspecified