Healthcare Provider Details

I. General information

NPI: 1538841598
Provider Name (Legal Business Name): ALYSSA JO ORTEGON MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E SAVANNAH AVE STE 101
MCALLEN TX
78503-1241
US

IV. Provider business mailing address

110 E SAVANNAH AVE BLDG C101
MCALLEN TX
78503-1242
US

V. Phone/Fax

Practice location:
  • Phone: 956-686-2626
  • Fax: 956-686-1616
Mailing address:
  • Phone: 956-686-2626
  • Fax: 956-686-1616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number806402
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1130832
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number806402
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: