Provider Demographics
NPI:1376648816
Name:ORTEGA, HILARIO F (DC)
Entity Type:Individual
Prefix:DR
First Name:HILARIO
Middle Name:F
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 E AMADOR AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-3308
Mailing Address - Country:US
Mailing Address - Phone:505-527-9107
Mailing Address - Fax:
Practice Address - Street 1:544 E AMADOR AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-3308
Practice Address - Country:US
Practice Address - Phone:505-527-9107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM594111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMT40990Medicare ID - Type UnspecifiedMEDICARE