MEDICARE: DR. JUAN CARLOS ORTIZ M.D.

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	208D00000X	General Practice Physician	12254	PR

General Provider Information

NPI Number	:	1265430631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN CARLOS ORTIZ M.D.

Provider Business Mailing Address
First Line	:	2889 REED RD APT 1310
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-2385
Country	:	US
Telephone Number	:	356-715-4023
Fax Number	:

Provider Business Practice Location Address
First Line	:	2889 REED RD APT 1310
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-2385
Country	:	US
Telephone Number	:	346-715-4023
Fax Number	:

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	09/15/2025

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