Provider Demographics
NPI:1770233074
Name:GARCIA ORTIZ, HECTOR EDUARDO
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:EDUARDO
Last Name:GARCIA ORTIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 APACHE LOOP SW
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4234
Mailing Address - Country:US
Mailing Address - Phone:505-908-4476
Mailing Address - Fax:
Practice Address - Street 1:541 APACHE LOOP SW
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4234
Practice Address - Country:US
Practice Address - Phone:505-908-4476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM406106225XE0001X
171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification