Healthcare Provider Details

I. General information

NPI: 1821163429
Provider Name (Legal Business Name): HENRY A. MENTZ III M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 POST OAK PKWY SUITE 2260
HOUSTON TX
77027-3421
US

IV. Provider business mailing address

12727 KIMBERLEY LN SUITE 300
HOUSTON TX
77024-4047
US

V. Phone/Fax

Practice location:
  • Phone: 713-799-9999
  • Fax: 713-799-1925
Mailing address:
  • Phone: 713-799-9999
  • Fax: 713-722-8998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberH9382
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: