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General NPI Number Information
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NPI Number | 1417140856
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Entity Type | Organization
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Legal Business Name | BETTY ELIZABETH ORTIZ
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 129 PALENCIA AVE
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City | LAREDO
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State | TX
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Zip | 78046-8524
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Country | US
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Telephone | 956-753-9205
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Fax |
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Provider Business Mailing Address
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Address Line | 129 PALENCIA AVE
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City | LAREDO
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State | TX
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Zip | 78046-8524
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Country | US
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Telephone | 956-753-9205
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Fax |
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Authorized Official
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Title or Position | OWNER OPERATOR
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Name | MS. BETTY ELIZABETH ORTIZ
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Credential | PROVIDER
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Telephone | 956-753-9205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 120939
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License Number State | TX
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