Provider Demographics
NPI:1437472602
Name:ANGELO C MENDEZ M. D. P. A.
Entity Type:Organization
Organization Name:ANGELO C MENDEZ M. D. P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:C
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-329-0389
Mailing Address - Street 1:1600 W COLLEGE ST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3580
Mailing Address - Country:US
Mailing Address - Phone:817-329-0389
Mailing Address - Fax:817-421-1416
Practice Address - Street 1:1600 W COLLEGE ST
Practice Address - Street 2:SUITE 340
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3580
Practice Address - Country:US
Practice Address - Phone:817-329-0389
Practice Address - Fax:817-421-1416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty