Provider Demographics
NPI:1619983996
Name:CORTEZ, MONIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W DEAN KEETON ST STOP A3900
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78712-1107
Mailing Address - Country:US
Mailing Address - Phone:512-475-8235
Mailing Address - Fax:512-475-9693
Practice Address - Street 1:100 W DEAN KEETON ST STOP A3900
Practice Address - Street 2:UNIVERSITY HEALTH SERVICES
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712-1107
Practice Address - Country:US
Practice Address - Phone:512-471-4955
Practice Address - Fax:512-475-8335
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1826207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144161003Medicaid
TX144161002Medicaid
TX144161002Medicaid
TX8K0654Medicare PIN
TX8988B5Medicare PIN