Provider Demographics
NPI:1124104823
Name:MENDIOLA, AROLDO (RPH)
Entity type:Individual
Prefix:MR
First Name:AROLDO
Middle Name:
Last Name:MENDIOLA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 N CONWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4004
Mailing Address - Country:US
Mailing Address - Phone:956-584-9828
Mailing Address - Fax:956-584-9458
Practice Address - Street 1:1618 N CONWAY AVE
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4004
Practice Address - Country:US
Practice Address - Phone:956-584-9828
Practice Address - Fax:956-584-9458
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3967560001Medicare ID - Type Unspecified