Provider Demographics
NPI:1225592769
Name:ORDONEZ, CAEZAR
Entity Type:Individual
Prefix:
First Name:CAEZAR
Middle Name:
Last Name:ORDONEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13294 COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-8014
Mailing Address - Country:US
Mailing Address - Phone:214-960-8307
Mailing Address - Fax:
Practice Address - Street 1:525 SE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-2834
Practice Address - Country:US
Practice Address - Phone:503-623-8301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137746363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily