MEDICARE: PAUL MENDOZA O.D.

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	152W00000X	Optometrist	5258 TG	TX

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	:	1548277320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL MENDOZA O.D.

Provider Business Mailing Address
First Line	:	PO BOX 181473
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-8473
Country	:	US
Telephone Number	:	214-643-6552
Fax Number	:	833-211-6593

Provider Business Practice Location Address
First Line	:	1151 N BUCKNER BLVD STE 407
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3407
Country	:	US
Telephone Number	:	214-643-6552
Fax Number	:	833-211-6593

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	06/19/2026

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Directions to “ PAUL MENDOZA O.D.” Practice Location

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