NPI Code Detail JSON Logo

1063626455 NPI number — DANIEL MENDOZA REQUENA MD

NPI Number: 1063626455
Health Care Provider/Practitioner: DANIEL MENDOZA REQUENA MD

Information about “1063626455” NPI (DANIEL MENDOZA REQUENA MD) exists in 1063626455 in HTML format HTML  |  1063626455 in plain Text format TXT  |  1063626455 in PDF (Portable Document Format) PDF  |  1063626455 in an XML format XML  formats.

NPI Number : 1063626455 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1063626455",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MENDOZA REQUENA",
    "FirstName": "DANIEL",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MENDOZA",
    "OtherFirstName": "DANIEL",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "2700 CULLEN BLVD UNIT 841696",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PEARLAND",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77584-0838",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "713-955-2047",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2734 SUNRISE BLVD STE 311",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PEARLAND",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77584-8709",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "281-858-3904",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/09/2007",
    "LastUpdateDate": "10/06/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207RI0200X",
        "TaxonomyName": "Infectious Disease Physician",
        "LicenseNumber": "Q2927",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.