Provider Demographics
NPI:1205989779
Name:DOS HERMANAS ORTIZ, INC
Entity type:Organization
Organization Name:DOS HERMANAS ORTIZ, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUNIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-200-8502
Mailing Address - Street 1:10803 GULFDALE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-3639
Mailing Address - Country:US
Mailing Address - Phone:210-200-8502
Mailing Address - Fax:210-200-5161
Practice Address - Street 1:10803 GULFDALE ST STE 250
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-3639
Practice Address - Country:US
Practice Address - Phone:210-200-8502
Practice Address - Fax:210-200-5161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005304251E00000X
253Z00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D0027717OtherCLIA NUMBER
TX024343801Medicaid
TX459303Medicare Oscar/Certification