Healthcare Provider Details

I. General information

NPI: 1386939122
Provider Name (Legal Business Name): MARIA CARMENZA MEJIA M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 KIRBY DR 100
HOUSTON TX
77098-3900
US

IV. Provider business mailing address

3701 KIRBY DR 100
HOUSTON TX
77098-3900
US

V. Phone/Fax

Practice location:
  • Phone: 713-798-7700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME120049
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number45058
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberS6687
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: