Provider Demographics
NPI:1639393226
Name:MENDES-NETO, ODORINDO (MD)
Entity Type:Individual
Prefix:
First Name:ODORINDO
Middle Name:
Last Name:MENDES-NETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:MENDES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8711 RIPPLING WATER DR
Mailing Address - Street 2:
Mailing Address - City:SUGARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:281-545-2922
Mailing Address - Fax:281-545-2922
Practice Address - Street 1:8711 RIPPLING WATER DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6976
Practice Address - Country:US
Practice Address - Phone:281-545-2922
Practice Address - Fax:281-545-2922
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3938207VG0400X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX034091102Medicaid
TX008J50Medicare PIN