Provider Demographics
NPI:1851746812
Name:ROXANNA ORTIZ CSA PLLC
Entity Type:Organization
Organization Name:ROXANNA ORTIZ CSA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MISS
Authorized Official - First Name:ROXANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-298-6012
Mailing Address - Street 1:1333 OLD SPANISH TRL STE G # 195
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1841
Mailing Address - Country:US
Mailing Address - Phone:713-298-6012
Mailing Address - Fax:
Practice Address - Street 1:1333 OLD SPANISH TRL STE G # 195
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1841
Practice Address - Country:US
Practice Address - Phone:713-298-6012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty