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General NPI Number Information
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NPI Number | 1033190111
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Entity Type | Organization
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Legal Business Name | ERNEST MENDOZA, MD PA
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 08/03/2007
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Provider Practice Location Address
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Address Line | 1330 KINGWOOD DR SUITE 100
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City | HUMBLE
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State | TX
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Zip | 77339-3038
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Country | US
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Telephone | 281-361-6500
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Fax | 281-361-6501
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Provider Business Mailing Address
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Address Line | 1330 KINGWOOD DR SUITE 100
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City | HUMBLE
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State | TX
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Zip | 77339-3038
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Country | US
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Telephone | 281-361-6500
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Fax | 281-361-6501
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERNEST J MENDOZA
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Credential | M.D.
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Telephone | 281-361-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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