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General NPI Number Information
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NPI Number | 1285043042
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Entity Type | Organization
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Legal Business Name | CARLOS MENDEZ, MD, LLC
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Dates
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Enumeration Date | 08/06/2014
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 539 E PRUDHOMME ST
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City | OPELOUSAS
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State | LA
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Zip | 70570-6499
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Country | US
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Telephone | 337-684-2299
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Fax | 337-684-2244
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Provider Business Mailing Address
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Address Line | PO BOX 181
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City | CHURCH POINT
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State | LA
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Zip | 70525-0181
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Country | US
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Telephone | 337-684-2299
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Fax | 337-684-2244
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARLOS MENDEZ
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Credential |
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Telephone | 337-684-2299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD200916
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License Number State | LA
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