Provider Demographics
NPI:1275724882
Name:JORGE A ORTEGON MD PA
Entity Type:Organization
Organization Name:JORGE A ORTEGON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-630-4155
Mailing Address - Street 1:PO BOX 4647
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4647
Mailing Address - Country:US
Mailing Address - Phone:956-630-1225
Mailing Address - Fax:956-630-1841
Practice Address - Street 1:2821 MICHAEL ANGELO
Practice Address - Street 2:SUITE 300
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1404
Practice Address - Country:US
Practice Address - Phone:956-630-1225
Practice Address - Fax:956-630-1841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6668207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0079MNOtherBCBS GROUP
TX119496OtherCOMMERCIAL NETWORK
TX135925100OtherCOMMERCIAL
TX172028601Medicaid
TX8S0570OtherBCBS
TX970007388OtherMEDICARE RAILROAD
TX8S0570OtherBCBS
TX00311YMedicare PIN