Provider Demographics
NPI:1871590588
Name:ORTEGA, ALONZO (DO)
Entity type:Individual
Prefix:
First Name:ALONZO
Middle Name:
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:517 SW MILITARY DR STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1639
Mailing Address - Country:US
Mailing Address - Phone:210-921-0322
Mailing Address - Fax:210-921-1451
Practice Address - Street 1:517 SW MILITARY DR STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1639
Practice Address - Country:US
Practice Address - Phone:210-921-0322
Practice Address - Fax:210-921-1451
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2023-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH6485207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1169179-04OtherWELLMED MEDICAID
TXTXB130977OtherWELLMED MEDICARE
F88160Medicare UPIN
TX1169179-04OtherWELLMED MEDICAID