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General NPI Number Information
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NPI Number | 1912412834
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Entity Type | Individual
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Provider Name | EILEEN SANDERS MENDEZ MD
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Gender | Female
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Dates
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Enumeration Date | 12/14/2017
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 4615 ALAMEDA AVE
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City | EL PASO
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State | TX
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Zip | 79905-2702
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Country | US
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Telephone | 915-521-7789
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Fax |
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Provider Business Mailing Address
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Address Line | 240 DESERT PASS ST APT 1211
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City | EL PASO
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State | TX
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Zip | 79912-3624
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Country | US
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Telephone | 703-332-9173
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 14529
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP10065211
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD2021-0869
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License Number State | NM
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