MEDICARE: DR. CONRADO JOSE ORDONEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	P8966	MI
2	207Q00000X	Family Medicine Physician	P8966	TX
3	207R00000X	Internal Medicine Physician	P8966	TX
4	207Q00000X	Family Medicine Physician	BP10040275	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043506777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CONRADO JOSE ORDONEZ MD

Provider Business Mailing Address
First Line	:	5633 AVENUE I
Second Line	:
City	:	ROSENBERG
State	:	TX
Zip	:	77471-6191
Country	:	US
Telephone Number	:	281-238-0443
Fax Number	:	281-238-0899

Provider Business Practice Location Address
First Line	:	5633 AVENUE I STE A
Second Line	:
City	:	ROSENBERG
State	:	TX
Zip	:	77471-6192
Country	:	US
Telephone Number	:	832-788-5092
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2011
Last Update Date	:	12/10/2025

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