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VIVIANA LAUREN LONGORIA-ORTIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP-PC

Contact information

Practice address
1325 PENNSYLVANIA AVE STE 740, FORT WORTH, TX 76104-2144
(817) 250-5435
Mailing address
5316 FALLEN LEAF ST, FORT WORTH, TX 76179-1548
(817) 658-8029

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP137387
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1689778938
TX
Enumeration date
09/08/2006
Last updated
04/30/2018
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