Provider Demographics
NPI:1023288990
Name:ORTIZ, ARTURO A (MD)
Entity type:Individual
Prefix:
First Name:ARTURO
Middle Name:A
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 E KIKA DE LA GARZA
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572
Mailing Address - Country:US
Mailing Address - Phone:956-585-4241
Mailing Address - Fax:956-581-6611
Practice Address - Street 1:1104 E KIKA DE LA GARZA
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572
Practice Address - Country:US
Practice Address - Phone:956-585-4241
Practice Address - Fax:956-581-6611
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1873207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092698201Medicaid
00GF83Medicare PIN
TX092698201Medicaid