Provider Demographics
NPI:1841498375
Name:MENDEZ RAMIREZ, JOSE MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:MARIA
Last Name:MENDEZ RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 14232
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88013-4232
Mailing Address - Country:US
Mailing Address - Phone:575-532-5455
Mailing Address - Fax:575-532-5641
Practice Address - Street 1:1998 N MOTEL BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-4100
Practice Address - Country:US
Practice Address - Phone:575-541-5941
Practice Address - Fax:575-541-5048
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7144207R00000X
NMMD2016-0082207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM17351006Medicaid
TX333765YK5VMedicare PIN