Healthcare Provider Details

I. General information

NPI: 1346268513
Provider Name (Legal Business Name): CARLOS E MENENDEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 02/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 HUEBNER RD SUITE 330
SAN ANTONIO TX
78240-1545
US

IV. Provider business mailing address

9150 HUEBNER RD SUITE 330
SAN ANTONIO TX
78240-1545
US

V. Phone/Fax

Practice location:
  • Phone: 210-692-7684
  • Fax: 210-692-1814
Mailing address:
  • Phone: 210-692-7684
  • Fax: 210-692-1814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberE3064
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: