Provider Demographics
NPI:1003596818
Name:JAVIER VAZQUEZ ORTIZ M.D., PLLC
Entity Type:Organization
Organization Name:JAVIER VAZQUEZ ORTIZ M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:MIGDOEL
Authorized Official - Last Name:VAZQUEZORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-220-7016
Mailing Address - Street 1:2705 HOSPITAL DR STE 202
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5776
Mailing Address - Country:US
Mailing Address - Phone:361-220-7016
Mailing Address - Fax:361-894-6373
Practice Address - Street 1:2705 HOSPITAL DR STE 202
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5776
Practice Address - Country:US
Practice Address - Phone:361-220-7016
Practice Address - Fax:361-894-6373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty