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General NPI Number Information
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NPI Number | 1265602445
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Entity Type | Individual
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Provider Name | NYDIA YARITZA CAMACHO ORTIZ PH. D.
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Gender | Female
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 9500 RAY WHITE RD STE 200
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City | FORT WORTH
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State | TX
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Zip | 76244-9105
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Country | US
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Telephone | 787-364-3898
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Fax | 833-694-0829
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Provider Business Mailing Address
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Address Line | 5701 GUNNISON TURN RD
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City | AUSTIN
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State | TX
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Zip | 78738-0009
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Country | US
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Telephone | 787-364-3898
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2946
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 37749
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License Number State | TX
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