Provider Demographics
NPI:1336034032
Name:ORTHOLIVE MEDICAL GROUP - TX PA
Entity type:Organization
Organization Name:ORTHOLIVE MEDICAL GROUP - TX PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GREIWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-479-9102
Mailing Address - Street 1:1311 VINE ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-7118
Mailing Address - Country:US
Mailing Address - Phone:513-479-9102
Mailing Address - Fax:513-306-4004
Practice Address - Street 1:5900 BALCONES DR STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4298
Practice Address - Country:US
Practice Address - Phone:866-456-7846
Practice Address - Fax:513-306-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty