Provider Demographics
NPI:1275262032
Name:DE LA PAZ HEALTH CARE
Entity Type:Organization
Organization Name:DE LA PAZ HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LEOVARES
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-905-3520
Mailing Address - Street 1:710 E CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-4640
Mailing Address - Country:US
Mailing Address - Phone:972-905-3520
Mailing Address - Fax:972-278-3485
Practice Address - Street 1:710 E CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-4640
Practice Address - Country:US
Practice Address - Phone:972-905-3520
Practice Address - Fax:972-278-3485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1760445936Medicaid