MEDICARE: SARAH ORTIZ RDN, LD

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	133V00000X	Registered Dietitian	DT86563	TX

General Provider Information

NPI Number	:	1487236519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ORTIZ RDN, LD

Provider Business Mailing Address
First Line	:	2343 HANKINSON LN
Second Line	:
City	:	FATE
State	:	TX
Zip	:	75189-5138
Country	:	US
Telephone Number	:	214-674-5123
Fax Number	:

Provider Business Practice Location Address
First Line	:	5830 GRANITE PKWY # 100-344
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-6771
Country	:	US
Telephone Number	:	469-991-9865
Fax Number	:

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

Provider Enumeration Date	:	04/27/2021
Last Update Date	:	05/05/2022

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