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General NPI Number Information
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NPI Number | 1700586286
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Entity Type | Individual
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Provider Name | ESMERALDA HERNANDEZ ORTIZ
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Gender | Female
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 03/03/2023
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Provider Practice Location Address
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Address Line | 475 ELM ST
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City | LEWISVILLE
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State | TX
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Zip | 75057-3762
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Country | US
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Telephone | 570-432-3244
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Fax |
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Provider Business Mailing Address
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Address Line | 2006 SAM HOUSTON BLVD
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City | CARROLLTON
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State | TX
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Zip | 75006-7646
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Country | US
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Telephone | 469-328-7472
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 123244
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License Number State | TX
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