Healthcare Provider Details

I. General information

NPI: 1326650821
Provider Name (Legal Business Name): JULIA MARIE ONTIVEROS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 HOUSTON ST
PLAINVIEW TX
79072-7905
US

IV. Provider business mailing address

2700 YONKERS ST
PLAINVIEW TX
79072-1826
US

V. Phone/Fax

Practice location:
  • Phone: 806-291-4470
  • Fax:
Mailing address:
  • Phone: 806-293-2636
  • Fax: 806-213-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95034109
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1008919
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1008919
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: