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General NPI Number Information
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NPI Number | 1265804454
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Entity Type | Individual
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Provider Name | GABRIEL MENDOZA AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 3280 JOE BATTLE BLVD
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City | EL PASO
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State | TX
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Zip | 79938-2622
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Country | US
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Telephone | 915-832-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 TIERRA MURCIA ST
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City | EL PASO
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State | TX
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Zip | 79938-2386
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Country | US
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Telephone | 915-269-7772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP1269307
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License Number State | TX
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