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General NPI Number Information
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NPI Number | 1265941447
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Entity Type | Organization
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Legal Business Name | MENDOZA FOOT & ANKLE CENTER PC
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Dates
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Enumeration Date | 09/20/2017
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Last Update Date | 09/20/2017
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Provider Practice Location Address
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Address Line | 3443 DICKERSON PIKE STE 500
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City | NASHVILLE
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State | TN
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Zip | 37207-2599
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Country | US
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Telephone | 615-860-8282
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Fax | 615-860-8258
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Provider Business Mailing Address
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Address Line | 336 SUMNER HALL DR
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City | GALLATIN
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State | TN
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Zip | 37066-3129
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Country | US
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Telephone | 615-452-8899
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Fax | 615-452-8919
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL MENDOZA
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Credential | DPM
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Telephone | 615-452-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | DPM000000442
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License Number State |
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