Provider Demographics
NPI:1447891189
Name:ORTEGA HERRERA, YAMISEL
Entity type:Individual
Prefix:
First Name:YAMISEL
Middle Name:
Last Name:ORTEGA HERRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18511 KINGS LYNN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3219
Mailing Address - Country:US
Mailing Address - Phone:786-307-6458
Mailing Address - Fax:
Practice Address - Street 1:18511 KINGS LYNN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3219
Practice Address - Country:US
Practice Address - Phone:786-307-6458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX963114163W00000X
TX1109026363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse