Healthcare Provider Details

I. General information

NPI: 1518476621
Provider Name (Legal Business Name): KRISTA E ORTIZ PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2017
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 RADAM LN
AUSTIN TX
78745-1172
US

IV. Provider business mailing address

8240 N MOPAC EXPY STE 100
AUSTIN TX
78759-8869
US

V. Phone/Fax

Practice location:
  • Phone: 512-788-9688
  • Fax: 512-443-5055
Mailing address:
  • Phone: 512-687-1970
  • Fax: 512-407-9010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1324186
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: