Provider Demographics
NPI:1013586957
Name:ORTUS MD PA
Entity Type:Organization
Organization Name:ORTUS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RANJITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RISHIKESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-982-7867
Mailing Address - Street 1:PO BOX 271827
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75027-1827
Mailing Address - Country:US
Mailing Address - Phone:972-982-7867
Mailing Address - Fax:
Practice Address - Street 1:3311 YUCCA DR
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2743
Practice Address - Country:US
Practice Address - Phone:972-982-7867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty