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Individual
MR. ALBERTO ORTIZ
Active
Individual
MR. ALBERTO ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01220
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306211902
—
TX
01
—
875N32
BC/BS #
TX
01
—
990005691
RAILROAD GBA - RAILROAD MEDICARE
TX
01
—
P01090522
RAILROAD MEDICARE PTAN
TX
Enumeration date
04/19/2006
Last updated
12/10/2012
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