Provider Demographics
NPI:1487048336
Name:ORTIZ, NATHAN L (AUD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:L
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 BABCOCK RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-3806
Mailing Address - Country:US
Mailing Address - Phone:210-695-4708
Mailing Address - Fax:210-695-4706
Practice Address - Street 1:5101 MEDICAL DR RM 234
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4801
Practice Address - Country:US
Practice Address - Phone:210-695-4708
Practice Address - Fax:210-695-4706
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2973231H00000X
TX80971237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter