Individual
MAURO ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4411 MEDICAL DR STE 300, SAN ANTONIO, TX 78229-3824
(210) 614-5400
(210) 614-2413
Mailing address
4411 MEDICAL DR STE 300, SAN ANTONIO, TX 78229-3824
(210) 614-5400
(210) 614-2413
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
L0472
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096380307
—
TX
01
—
8CM512
BCBS
TX
01
—
P00898261
RAILROAD MEDICARE
TX
01
—
TXB112458
MEDICARE
TX
Enumeration date
02/02/2006
Last updated
07/21/2022
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