| Jorge A. Ontiveros, M.d., P.a. | |
|
10705 Plano Rd Suite 200 Dallas TX 75238-5343 | |
| (214) 553-8545 | |
| (214) 553-9010 |
| Full Name | Jorge A. Ontiveros, M.d., P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 10705 Plano Rd, Dallas, Texas |
| Authorized Official Name and Position | Jorge Ontiveros (PRESIDENT) |
| Authorized Official Contact | 2145338545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jorge A. Ontiveros, M.d., P.a. Po Box 2024 Addison TX 75001-2024 Ph: () - | Jorge A. Ontiveros, M.d., P.a. 10705 Plano Rd Suite 200 Dallas TX 75238-5343 Ph: (214) 553-8545 |
| NPI Number | 1508993791 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 05/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508993791 | NPI | - | NPPES |
| DH1290 | Other | TX | RR MEDICARE |
| 0097QV | Other | TX | BCBS |
| 176862401 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | K7852 (Texas) | Primary |
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