Provider Demographics
NPI:1235722869
Name:MARQUEZ DE ORTIZ, MARIA VERONICA (FOSTER HOME)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:VERONICA
Last Name:MARQUEZ DE ORTIZ
Suffix:
Gender:F
Credentials:FOSTER HOME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11201 DICK LOTZ LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4606
Mailing Address - Country:US
Mailing Address - Phone:915-630-8030
Mailing Address - Fax:
Practice Address - Street 1:11201 DICK LOTZ LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-4606
Practice Address - Country:US
Practice Address - Phone:915-630-8030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLHOC19-00059253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency