Provider Demographics
NPI:1144410523
Name:RAY V. CORTEZ, MD PA
Entity Type:Organization
Organization Name:RAY V. CORTEZ, MD PA
Other - Org Name:ALL-STAR PEDIATRICS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:V
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-492-7827
Mailing Address - Street 1:16410 BLANCO RD STE 5
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1915
Mailing Address - Country:US
Mailing Address - Phone:210-492-7827
Mailing Address - Fax:210-492-7859
Practice Address - Street 1:16410 BLANCO RD STE 5
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1915
Practice Address - Country:US
Practice Address - Phone:210-492-7827
Practice Address - Fax:210-492-7859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4059208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1710901541OtherNPI TYPE I
TX0095QDOtherBCBS