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General NPI Number Information
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NPI Number | 1770609042
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Entity Type | Organization
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Legal Business Name | R & L ORTEGA PLLC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 520 N MONTE VISTA ST SUITE A
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City | ADA
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State | OK
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Zip | 74820-4674
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Country | US
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Telephone | 580-272-0922
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Fax | 580-272-0811
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Provider Business Mailing Address
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Address Line | 520 N MONTE VISTA ST SUITE A
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City | ADA
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State | OK
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Zip | 74820-4674
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Country | US
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Telephone | 580-272-0922
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Fax | 580-272-0811
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Authorized Official
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Title or Position | MANAGER
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Name | DR. LEANDRITA FLORES ORTEGA
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Credential | MD
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Telephone | 580-272-0922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 23586
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License Number State | OK
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