MEDICARE: OSCAR G MENDOZA III AA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367H00000X	Anesthesiologist Assistant	AA24	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063665651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSCAR G MENDOZA III AA

Provider Business Mailing Address
First Line	:	1321 UPLAND DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043-4718
Country	:	US
Telephone Number	:	305-205-4701
Fax Number	:	727-443-4206

Provider Business Practice Location Address
First Line	:	1755 CURIE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-2919
Country	:	US
Telephone Number	:	305-205-4701
Fax Number	:	727-443-4206

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	02/06/2024

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