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General NPI Number Information
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NPI Number | 1194864306
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Entity Type | Organization
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Legal Business Name | JAIME ORTIZ
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 502 E EXPRESSWAY 83 STE 16
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City | WESLACO
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State | TX
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Zip | 78596-4538
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Country | US
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Telephone | 956-969-9596
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Fax |
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Provider Business Mailing Address
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Address Line | 502 E EXPRESSWAY 83 STE 16
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City | WESLACO
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State | TX
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Zip | 78596-4538
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Country | US
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Telephone | 956-969-9596
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. JORGE LEE LOZANO
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Credential |
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Telephone | 956-969-9596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0077132
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License Number State | TX
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