Provider Demographics
NPI:1336737691
Name:GARCIA ORTEGA, ABRAHAM (MD)
Entity type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:
Last Name:GARCIA ORTEGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:PROF
Other - First Name:ABRAHAM
Other - Middle Name:
Other - Last Name:GARCIA ORTEGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:1704 17TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-2049
Mailing Address - Country:US
Mailing Address - Phone:615-587-3886
Mailing Address - Fax:
Practice Address - Street 1:THE UNIVERSITY OF OKLAHOMA 660 PARRINGTON OVAL
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73019-0001
Practice Address - Country:US
Practice Address - Phone:405-325-0311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001782363AM0700X
OK37746207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical