Provider Demographics
NPI:1639934003
Name:ORTEGA, HUNTER (HIS)
Entity Type:Individual
Prefix:
First Name:HUNTER
Middle Name:
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5402 SW LEE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-9521
Mailing Address - Country:US
Mailing Address - Phone:580-536-6122
Mailing Address - Fax:580-536-6141
Practice Address - Street 1:5402 SW LEE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-9521
Practice Address - Country:US
Practice Address - Phone:580-536-6122
Practice Address - Fax:580-536-6141
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1308237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist