Provider Demographics
NPI:1720097215
Name:ORTEGON, JORGE A (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:A
Last Name:ORTEGON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JORGE
Other - Middle Name:A
Other - Last Name:ORTEGON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PA
Mailing Address - Street 1:PO BOX 4647
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4647
Mailing Address - Country:US
Mailing Address - Phone:956-630-1225
Mailing Address - Fax:956-630-1841
Practice Address - Street 1:2821 MICHAEL ANGELO STE 300
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1404
Practice Address - Country:US
Practice Address - Phone:956-630-1225
Practice Address - Fax:956-630-1841
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6668207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135925100Other5
TX00283GOther2
TX119496Other1
TX089993203Medicaid
TX8S0570Other3
TX970007388Other4
TX970007388Other4
TX119496Other1