MEDICARE: DR. ABRAM ORTEGA DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	35368	TX
2	1223G0001X	General Practice Dentistry	DN26433	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508411372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABRAM ORTEGA DMD

Provider Business Mailing Address
First Line	:	512 PAUL JONES PASS
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-2924
Country	:	US
Telephone Number	:	210-421-6180
Fax Number	:

Provider Business Practice Location Address
First Line	:	3909 N IH 35 STE A1
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78722-1529
Country	:	US
Telephone Number	:	512-458-5600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2019
Last Update Date	:	09/13/2021

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