Provider Demographics
NPI:1972360808
Name:ORTIZ, DAVID (LMTI,NATUROPATH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:LMTI,NATUROPATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11500 NORTHWEST FWY STE 330
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-6546
Mailing Address - Country:US
Mailing Address - Phone:832-866-3153
Mailing Address - Fax:
Practice Address - Street 1:11500 NORTHWEST FWY STE 330
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-6546
Practice Address - Country:US
Practice Address - Phone:832-866-3153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
TXMI3939225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No175F00000XOther Service ProvidersNaturopath