Provider Demographics
NPI:1578763017
Name:ORTIZ LUGO, ANA H (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:H
Last Name:ORTIZ LUGO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7402 LAKE RIDGE PKWY APT 9211
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-0420
Mailing Address - Country:US
Mailing Address - Phone:787-344-7877
Mailing Address - Fax:
Practice Address - Street 1:7402 LAKE RIDGE PKWY APT 9211
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-0420
Practice Address - Country:US
Practice Address - Phone:787-344-7877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38880103TC0700X
PR3441103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical