Provider Demographics
NPI:1538603899
Name:ORTIZ, MARIA D (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:D
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E. 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NIXON
Mailing Address - State:TX
Mailing Address - Zip Code:78140-1148
Mailing Address - Country:US
Mailing Address - Phone:830-582-1100
Mailing Address - Fax:830-379-2325
Practice Address - Street 1:200 E. 2ND AVE
Practice Address - Street 2:
Practice Address - City:NIXON
Practice Address - State:TX
Practice Address - Zip Code:78140
Practice Address - Country:US
Practice Address - Phone:830-582-1100
Practice Address - Fax:830-379-2325
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM45567Medicaid