Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 1057776 | TX |
Y | 2251X0800X | Physical Therapist - Orthopedic | 1057776 | TX |
NPI | 1295207553 |
---|---|
Provider Name | Catherine Ortega |
First Address | San Antonio, TX 78201-3723 |
Second Address | San Antonio, TX 78215-1934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2018 |
Last Update Date | 27/12/2018 |