Healthcare Provider Details

I. General information

NPI: 1487276531
Provider Name (Legal Business Name): ANALISA ORTIZ MSRLS, CTRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 HORIZON HILL BLVD
SAN ANTONIO TX
78229-2258
US

IV. Provider business mailing address

1117 MORNING ROSE
SCHERTZ TX
78154-2846
US

V. Phone/Fax

Practice location:
  • Phone: 210-321-2700
  • Fax:
Mailing address:
  • Phone: 361-331-7353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number81976
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: