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NPI Code Detail

MEDICARE: MR. RICARDO MENDEZ PA

MEDICARE:  MR. RICARDO  MENDEZ  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA02228TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00767024OTHERTXRAILROAD MEDICARE

General Provider Information

NPI Number : 1528274487
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICARDO MENDEZ PA
Provider Business Mailing Address
First Line : 1200 STATE HIGHWAY 100 STE 5
Second Line :
City : PORT ISABEL
State : TX
Zip : 78578-2450
Country : US
Telephone Number : 956-943-6675
Fax Number : 956-943-6864
Provider Business Practice Location Address
First Line : 1200 STATE HIGHWAY 100 STE 5
Second Line :
City : PORT ISABEL
State : TX
Zip : 78578-2450
Country : US
Telephone Number : 956-943-6675
Fax Number : 956-943-6864
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 02/04/2010

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Directions to “ MR. RICARDO MENDEZ PA” Practice Location

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