Provider Demographics
NPI:1245242825
Name:OROZCO, AIDA M (OTR)
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:M
Last Name:OROZCO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 CORPUS CHRISTI ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-5208
Mailing Address - Country:US
Mailing Address - Phone:956-723-5700
Mailing Address - Fax:956-723-5706
Practice Address - Street 1:1020 CORPUS CHRISTI ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-5208
Practice Address - Country:US
Practice Address - Phone:956-723-5700
Practice Address - Fax:956-723-5706
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111920225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192715403Medicaid