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General NPI Number Information
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NPI Number | 1336540970
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Entity Type | Organization
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Legal Business Name | LAURA MENDIOLA, MD, PLLC
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 1119 FENWICK DRIVE SUITE 101
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City | LAREDO
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State | TX
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Zip | 78041-2971
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Country | US
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Telephone | 214-417-1350
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Fax | 888-872-3909
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Provider Business Mailing Address
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Address Line | 1119 FENWICK DRIVE SUITE 101
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City | LAREDO
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State | TX
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Zip | 78041-2971
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Country | US
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Telephone | 214-417-1350
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Fax | 888-872-3909
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Authorized Official
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Title or Position | OPHTHALMOLOGIST / OWNER
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Name | DR. LAURA LETICIA MENDIOLA
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Credential | M.D.
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Telephone | 214-417-1350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | N9744
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License Number State | TX
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