Provider Demographics
NPI:1598244899
Name:ORTIZ, CORY LEE (DPT)
Entity Type:Individual
Prefix:
First Name:CORY
Middle Name:LEE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 BEACHVIEW ST STE 110
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3704
Mailing Address - Country:US
Mailing Address - Phone:817-461-4257
Mailing Address - Fax:817-461-4257
Practice Address - Street 1:1130 BEACHVIEW ST STE 110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3704
Practice Address - Country:US
Practice Address - Phone:214-538-2559
Practice Address - Fax:844-364-8679
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1308590225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist