Provider Demographics
NPI:1194015297
Name:SCOTTY ORTEGA MD LLP
Entity type:Organization
Organization Name:SCOTTY ORTEGA MD LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTTY
Authorized Official - Middle Name:RAMIRO
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:323-321-3864
Mailing Address - Street 1:3001 N FAUDREE RD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-8875
Mailing Address - Country:US
Mailing Address - Phone:432-332-1386
Mailing Address - Fax:432-614-4178
Practice Address - Street 1:3001 N FAUDREE RD
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-8875
Practice Address - Country:US
Practice Address - Phone:432-332-1386
Practice Address - Fax:432-614-6272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty