MEDICARE: CESAR MENDOZA

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1104779149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CESAR MENDOZA

Provider Business Mailing Address
First Line	:	1220 W LOUIS HENNA BLVD
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-2300
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1220 W LOUIS HENNA BLVD
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-2300
Country	:	US
Telephone Number	:	214-280-5656
Fax Number	:

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

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	04/14/2026

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Directions to “ CESAR MENDOZA ” Practice Location

Language	Start Address	Practice Location

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