Provider Demographics
NPI:1366052045
Name:ORTIZ CONDE, KARLA MICHELLE (RD)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:MICHELLE
Last Name:ORTIZ CONDE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 ASHBURY ST APT 3215
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-2011
Mailing Address - Country:US
Mailing Address - Phone:787-667-5473
Mailing Address - Fax:
Practice Address - Street 1:6100 ASHBURY ST APT 3215
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-2011
Practice Address - Country:US
Practice Address - Phone:787-667-5473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered