Individual
MR. CHARLES E ORTEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PAC, MPAS
Contact information
Practice address
16901 DALLAS PKWY STE 206, ADDISON, TX 75001-5214
(214) 233-3094
(214) 241-1167
Mailing address
16901 DALLAS PKWY STE 206, ADDISON, TX 75001-5214
(214) 233-3094
(214) 241-1167
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02353
TX
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P19402
MEDICAL LICENSE
TX
01
—
PA02353
LICENSE
TX
Enumeration date
05/23/2007
Last updated
05/09/2025
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