Provider Demographics
NPI:1588209217
Name:ELSA S MENDOZA MD PA
Entity Type:Organization
Organization Name:ELSA S MENDOZA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CPA
Authorized Official - Prefix:
Authorized Official - First Name:JOSEFINA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MIRELES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-618-2300
Mailing Address - Street 1:680 PAREDES LINE RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2482
Mailing Address - Country:US
Mailing Address - Phone:956-541-1322
Mailing Address - Fax:
Practice Address - Street 1:680 PAREDES LINE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2482
Practice Address - Country:US
Practice Address - Phone:956-541-1322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty