Provider Demographics
NPI:1437557352
Name:MENDEZ, AVRIAN (PA-C)
Entity Type:Individual
Prefix:
First Name:AVRIAN
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 HWY 202
Mailing Address - Street 2:GARZA UNIT/UTMB
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102
Mailing Address - Country:US
Mailing Address - Phone:361-358-9890
Mailing Address - Fax:
Practice Address - Street 1:4250 HWY 202
Practice Address - Street 2:GARZA UNIT/UTMB
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102
Practice Address - Country:US
Practice Address - Phone:361-358-9890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05545363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical