Provider Demographics
NPI:1871724104
Name:ORDONEZ, MARIA GUADALUPE (ABOC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:GUADALUPE
Last Name:ORDONEZ
Suffix:
Gender:F
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 N EXPRESSWAY
Mailing Address - Street 2:STE 25 N.PARKPLAZA
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-1422
Mailing Address - Country:US
Mailing Address - Phone:956-554-7400
Mailing Address - Fax:956-554-7400
Practice Address - Street 1:814 N EXPRESSWAY
Practice Address - Street 2:STE. 25 N.PARKPLAZA
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-1422
Practice Address - Country:US
Practice Address - Phone:956-554-7400
Practice Address - Fax:956-554-7400
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160450156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician