Provider Demographics
NPI:1609246685
Name:ORTIZ, ANA ROSA (HIS)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:ROSA
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 E MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-2601
Mailing Address - Country:US
Mailing Address - Phone:214-821-3780
Mailing Address - Fax:214-821-3781
Practice Address - Street 1:6120 E MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-2601
Practice Address - Country:US
Practice Address - Phone:214-821-3780
Practice Address - Fax:214-821-3781
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80548237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist