Provider Demographics
NPI:1528060969
Name:ORTEGA, ANTONIO M (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:M
Last Name:ORTEGA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7101 N MESA ST
Mailing Address - Street 2:PMB 300
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3613
Mailing Address - Country:US
Mailing Address - Phone:915-544-9969
Mailing Address - Fax:915-544-9970
Practice Address - Street 1:1400 N EL PASO ST
Practice Address - Street 2:BUILDING D
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3437
Practice Address - Country:US
Practice Address - Phone:915-544-9969
Practice Address - Fax:915-544-9970
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TXK0970207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG31222Medicare UPIN
TX0011BAMedicare ID - Type Unspecified