Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | P1123 | TX |
N | 207QG0300X | Family Doctor - Geriatric Medicine | P1123 | TX |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | P1123 | TX |
NPI | 1821245473 |
---|---|
Provider Name | Dr. Jesus Roberto Ortiz |
First Address | Olmito, TX 78575-0787 |
Second Address | Brownsville, TX 78521-2442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2008 |
Last Update Date | 14/01/2022 |