MEDICARE: DR. ORLANDO ORTIZ JR. D.D.S.

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	18773	TX

General Provider Information

NPI Number	:	1922138569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ORLANDO ORTIZ JR. D.D.S.

Provider Business Mailing Address
First Line	:	6003 BELLAIRE BLVD
Second Line	:	SUITE B
City	:	HOUSTON
State	:	TX
Zip	:	77081-5401
Country	:	US
Telephone Number	:	713-666-8988
Fax Number	:	713-666-9245

Provider Business Practice Location Address
First Line	:	6003 BELLAIRE BLVD
Second Line	:	SUITE B
City	:	HOUSTON
State	:	TX
Zip	:	77081-5401
Country	:	US
Telephone Number	:	713-666-8988
Fax Number	:	713-666-9245

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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