MEDICARE: ANDREA MARIE ORTIZ

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	106S00000X	Behavior Technician		TX

General Provider Information

NPI Number	:	1720912298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA MARIE ORTIZ

Provider Business Mailing Address
First Line	:	13915 SKY HARBOR AVE
Second Line	:	12429 ROBERT DAVID DR
City	:	HORIZON CITY
State	:	TX
Zip	:	79928
Country	:	US
Telephone Number	:	915-297-7216
Fax Number	:

Provider Business Practice Location Address
First Line	:	13915 SKY HARBOR AVE
Second Line	:	12429 ROBERT DAVID DR
City	:	HORIZON CITY
State	:	TX
Zip	:	79928
Country	:	US
Telephone Number	:	915-297-7216
Fax Number	:

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

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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