Provider Demographics
NPI:1326650821
Name:ONTIVEROS, JULIA MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:MARIE
Last Name:ONTIVEROS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2700 YONKERS ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-1826
Mailing Address - Country:US
Mailing Address - Phone:806-293-2636
Mailing Address - Fax:806-213-1102
Practice Address - Street 1:715 HOUSTON ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-7905
Practice Address - Country:US
Practice Address - Phone:806-291-4470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1008919207Q00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine