Provider Demographics
NPI:1437499415
Name:MENDIOLA, RAMIRO
Entity Type:Individual
Prefix:
First Name:RAMIRO
Middle Name:
Last Name:MENDIOLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 BLUEBONNET TRL
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-3202
Mailing Address - Country:US
Mailing Address - Phone:469-260-6123
Mailing Address - Fax:469-209-0722
Practice Address - Street 1:337 BLUEBONNET TRL
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-3202
Practice Address - Country:US
Practice Address - Phone:469-260-6123
Practice Address - Fax:469-209-0722
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171WH0202X
TX13917149171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications