Provider Demographics
NPI:1790224715
Name:ENDER, ORIETA (IBCLC)
Entity Type:Individual
Prefix:
First Name:ORIETA
Middle Name:
Last Name:ENDER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2713 CREEK BEND CIR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-1843
Mailing Address - Country:US
Mailing Address - Phone:512-947-2203
Mailing Address - Fax:
Practice Address - Street 1:2713 CREEK BEND CIR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-1843
Practice Address - Country:US
Practice Address - Phone:512-947-2203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN