MEDICARE: FERNANDO MENDEZ P.A.

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	:	1689084675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FERNANDO MENDEZ P.A.

Provider Business Mailing Address
First Line	:	1001E TYLER AVE
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-7135
Country	:	US
Telephone Number	:	956-423-1194
Fax Number	:	866-394-0482

Provider Business Practice Location Address
First Line	:	95 E PRICE RD
Second Line	:	BLDG. E
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521-3578
Country	:	US
Telephone Number	:	956-504-4800
Fax Number	:

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

Provider Enumeration Date	:	04/30/2014
Last Update Date	:	01/02/2016

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