Healthcare Provider Details

I. General information

NPI: 1043485212
Provider Name (Legal Business Name): CATHIA MENDEZ-VARGAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 08/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 CAMINO LA COSTA
AUSTIN TX
78752-3930
US

IV. Provider business mailing address

1101 CAMINO LA COSTA
AUSTIN TX
78752-3930
US

V. Phone/Fax

Practice location:
  • Phone: 512-478-4939
  • Fax: 512-708-1835
Mailing address:
  • Phone: 512-478-4939
  • Fax: 512-708-1835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number17,142
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP4353
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number55778
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0055778
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: