Provider Demographics
NPI:1376855452
Name:SAIRE MENDOZA, MARDELI CATALINA (MD)
Entity type:Individual
Prefix:
First Name:MARDELI
Middle Name:CATALINA
Last Name:SAIRE MENDOZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 E BERT KOUN LOOP
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5663
Mailing Address - Country:US
Mailing Address - Phone:318-681-4282
Mailing Address - Fax:
Practice Address - Street 1:1449 E BERT KOUN LOOP
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5663
Practice Address - Country:US
Practice Address - Phone:318-681-4282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2025-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206313207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology