Provider Demographics
NPI:1053086942
Name:ORTEGA, MONICA ITZEL
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:ITZEL
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3908 UMAR AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5972
Mailing Address - Country:US
Mailing Address - Phone:956-270-1611
Mailing Address - Fax:
Practice Address - Street 1:3031 W ALBERTA RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3118
Practice Address - Country:US
Practice Address - Phone:956-972-0600
Practice Address - Fax:956-972-0604
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX420212355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX42021OtherTEXAS DEPARTMENT OF LICENSING AND REGISTRATION