Basic Information
| Provider Information | |||||||||
| NPI: | 1649433863 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MENDEZ | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | PEREZ | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7008 INDIANA AVE | ||||||||
| Address2: | STE. A | ||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794136114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8066988088 | ||||||||
| FaxNumber: | 8066988588 | ||||||||
| Practice Location | |||||||||
| Address1: | 7008 INDIANA AVE | ||||||||
| Address2: | STE. A | ||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794136114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8066988088 | ||||||||
| FaxNumber: | 8066988588 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2008 | ||||||||
| LastUpdateDate: | 06/02/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | BP10032240 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | N5863 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.