Provider Demographics
NPI:1548665474
Name:FRITSCHE, ANTONIA ORTEGA (LMT)
Entity type:Individual
Prefix:MRS
First Name:ANTONIA
Middle Name:ORTEGA
Last Name:FRITSCHE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23522 BAYLEAF DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-6277
Mailing Address - Country:US
Mailing Address - Phone:281-455-9237
Mailing Address - Fax:
Practice Address - Street 1:9004 FOREST XING
Practice Address - Street 2:SUITE C
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-1197
Practice Address - Country:US
Practice Address - Phone:281-455-9237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT111823225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist