Healthcare Provider Details

I. General information

NPI: 1801149042
Provider Name (Legal Business Name): ANA ISABEL ORTEGA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2012
Last Update Date: 01/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20627 SADDLE CP
SAN ANTONIO TX
78259-2088
US

IV. Provider business mailing address

20627 SADDLE CP
SAN ANTONIO TX
78259-2088
US

V. Phone/Fax

Practice location:
  • Phone: 915-497-3598
  • Fax: 866-811-2590
Mailing address:
  • Phone: 915-497-3598
  • Fax: 866-811-2590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-12-12352
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: