Provider Demographics
NPI:1184658213
Name:MENDOZA-RAMIREZ, JORGE SALVADOR (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:SALVADOR
Last Name:MENDOZA-RAMIREZ
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9226 HAMMERLY BLVD
Mailing Address - Street 2:CLINICA PEDIATRICA HISPANA
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-5567
Mailing Address - Country:US
Mailing Address - Phone:713-468-0222
Mailing Address - Fax:713-468-0233
Practice Address - Street 1:9226 HAMMERLY BLVD
Practice Address - Street 2:CLINICA PEDIATRICA HISPANA
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-5567
Practice Address - Country:US
Practice Address - Phone:713-468-0222
Practice Address - Fax:713-468-0233
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX13898208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155645802Medicaid