Provider Demographics
NPI:1104253962
Name:MENDEZ MEDICAL CONSULTING, PLLC
Entity type:Organization
Organization Name:MENDEZ MEDICAL CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESPIRIDION
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MPAS, PA-C
Authorized Official - Phone:512-595-3045
Mailing Address - Street 1:825 W ROYAL LN
Mailing Address - Street 2:SUITE 140
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-3601
Mailing Address - Country:US
Mailing Address - Phone:512-595-3045
Mailing Address - Fax:
Practice Address - Street 1:825 W ROYAL LN
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3601
Practice Address - Country:US
Practice Address - Phone:512-595-3045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3628207Q00000X
TXPA05410363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty