Provider Demographics
NPI:1124508932
Name:ORTIZ-FLORES, MELINDA (PTA)
Entity type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:
Last Name:ORTIZ-FLORES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 LOOP 459
Mailing Address - Street 2:
Mailing Address - City:MATHIS
Mailing Address - State:TX
Mailing Address - Zip Code:78368-1804
Mailing Address - Country:US
Mailing Address - Phone:361-547-3318
Mailing Address - Fax:361-547-3737
Practice Address - Street 1:1220 LOOP 459
Practice Address - Street 2:
Practice Address - City:MATHIS
Practice Address - State:TX
Practice Address - Zip Code:78368-1804
Practice Address - Country:US
Practice Address - Phone:361-371-9093
Practice Address - Fax:361-371-9093
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2050440225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant