Provider Demographics
NPI:1457890956
Name:ORTIZ, NOE NILO JR
Entity Type:Individual
Prefix:MR
First Name:NOE
Middle Name:NILO
Last Name:ORTIZ
Suffix:JR
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 1:657 SPRINGMART BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-4328
Mailing Address - Country:US
Mailing Address - Phone:956-525-8087
Mailing Address - Fax:956-350-8486
Practice Address - Street 1:657 SPRINGMART BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-4328
Practice Address - Country:US
Practice Address - Phone:956-525-8087
Practice Address - Fax:956-350-8486
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health