Healthcare Provider Details

I. General information

NPI: 1235701723
Provider Name (Legal Business Name): CAROLYN CHRISTINE ORTIZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3213 I 30 STE 110
MESQUITE TX
75150-2603
US

IV. Provider business mailing address

5900 BALCONES DR # 32651
AUSTIN TX
78731-4257
US

V. Phone/Fax

Practice location:
  • Phone: 469-795-3311
  • Fax: 903-230-9516
Mailing address:
  • Phone: 469-795-3311
  • Fax: 903-230-9516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1047282
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: