Provider Demographics
NPI:1477914588
Name:ORTEGA, LUIS FELIPE
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:FELIPE
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 ARBOR HILL WAY
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:78612-3332
Mailing Address - Country:US
Mailing Address - Phone:512-653-1189
Mailing Address - Fax:
Practice Address - Street 1:259 ARBOR HILL WAY
Practice Address - Street 2:
Practice Address - City:CEDAR CREEK
Practice Address - State:TX
Practice Address - Zip Code:78612-3332
Practice Address - Country:US
Practice Address - Phone:512-653-1189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications