# MR. ALBERTO ORTIZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1720043060
- **Gender:** Man
- **Credential:** P.A.-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA01220 | TX | Yes |

## Other

- **Enumeration date:** 04/19/2006
- **Last updated:** 12/10/2012

## 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 |