Basic Information
| Provider Information | |||||||||
| NPI: | 1699118307 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MENDOZA | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | AMERICO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8409 CORNWALL DR | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787486509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127798761 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1801 N BEDELL AVE | ||||||||
| Address2: | |||||||||
| City: | DEL RIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8307689200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2013 | ||||||||
| LastUpdateDate: | 06/07/2018 | ||||||||
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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 | R0452 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.