Provider Demographics
NPI:1528195120
Name:ORTALIZ, RAMON LACSON (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:LACSON
Last Name:ORTALIZ
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Gender:M
Credentials:MD
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Mailing Address - Street 1:36000 DARNALL LOOP
Mailing Address - Street 2:CARL R DARNALL ARMY MEDICAL CENTER
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:254-285-6229
Mailing Address - Fax:254-285-6193
Practice Address - Street 1:36000 DARNALL LOOP
Practice Address - Street 2:CARL R DARNALL ARMY MEDICAL CENTER
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-285-6229
Practice Address - Fax:254-285-6193
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IA20039208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics