Individual ProviderGuillermo Montalban BravoInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1515 Holcombe Blvd, Houston, TX 77030-4000(713) 792-6161(713) 792-2991PECOS EnrollmentBased on the most recent information from CMS, provider Guillermo Montalban Bravo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:26 AM.Profile DetailsProvider ID1487156782Provider TypeIndividualFull NameMontalban Bravo, GuillermoCredentialMDGenderMaleSole ProprietorNoEnumeration Date3/2/2018Last Updated6/25/2025Contact InformationPractice LocationPractice Address1515 Holcombe Blvd, Houston, TX 77030-4000Phone(713) 792-6161FaxUnlisted FaxMailing LocationMailing AddressP O Box 4439, Houston, TX 77210-4439Phone(713) 792-2991FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207RH0003XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseU7475TexasCode207RH0003XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense46000TexasProvider IdentifiersIDDescriptionIssuerID382460902DescriptionOtherIssuerCSHCN TPITexasID382460901DescriptionMedicaidIssuerUnlistedTexas