Provider Demographics
NPI:1316704273
Name:ORTEGA, RUDY ALEXANDER (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:RUDY
Middle Name:ALEXANDER
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 LOS SIGLOS DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7512
Mailing Address - Country:US
Mailing Address - Phone:915-539-0238
Mailing Address - Fax:
Practice Address - Street 1:5857 N MESA ST STE 23
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4653
Practice Address - Country:US
Practice Address - Phone:915-455-1159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13900202251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports