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General NPI Number Information
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NPI Number | 1336513951
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Entity Type | Organization
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Legal Business Name | DR. LATINO FAMILY CLINIC II PLLC
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 104 JASON ST
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City | VICTORIA
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State | TX
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Zip | 77901-2628
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Country | US
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Telephone | 361-703-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 104 JASON ST
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City | VICTORIA
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State | TX
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Zip | 77901-2628
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Country | US
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Telephone | 361-703-5000
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ELIZABETH ORDONEZ
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Credential |
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Telephone | 281-558-0722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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